Professional Documents
Culture Documents
Hypertension
Hypertension
DISCLOSURE
Any Drug or Product Mentioned in this Discussion is Purely Illustrative and not a Commercial Endorsement All Opinions Expressed Are the Biases of the Speaker (Which are Considerable)
National Heart, Lung, and Blood Institute National High Blood Pressure Education Program
Eighth Report of the The Seventh Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 8)
JNC 8
Cumulative CV Risk with Non-Hypertensive BP (SBP < 140 mmHg and DBP < 90 mm Hg)
PATTERNS OF AMBULATORY BP
White Coat Hypertension Hypertensive Dipping
Masked Hypertension
Hypertensive Non-Dipping
MASKED HYPERTENSION
Relative CV Risk in Diabetics
Untreated Treated
Normotensive Masked
Stage 2 Hypertension
>160
or >100
Yes
*Treatment determined by highest BP category. Initial combined therapy should be used cautiously in those at risk for orthostatic hypotension. Treat patients with chronic kidney disease or diabetes to BP goal of <130/80 mmHg.
Americansconsumetoomuchsalt
www.cdc.gov/features/dsSodium
DietaryPotassiumIntakeinU.S.
Sodium (2,300 mg) MALE
(30-50 yo)
FEMALE WHITE
(>20 yo)
BLACK PRIMITIVE
*2,219 mg
4 - 10
Potassium/Sodium Intake
www.ars.usda.gov/services/docs.htm?docid=18349
R = Salt-resistant S = Salt-sensitive 35-50% White HTN 65-80% Black HTN N = Normotensive H = Hypertensive
SystolicBP
Uncontrolled(SBP>140) (146mmHg) Usual(SPB130139) (131mmHg) Tight(SPB<130) (122mmHg)
INTENSIVEBPCONTROLINDM TheACCORDBPTrial
4733ptsType2DM: >40yo+CVdiseaseOR >55yo+ASHD,LVH,albuminuria
Fatal MI or CVA,CVDeath PrimaryOutcome:NonFatalNon MIor CVA; CV Death
IntensiveRx:
NEngJMed362:1575,2010
Hypertension:37869, 2011
Death-Any Cause