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Hypertention Urgency/emergency
Hypertention Urgency/emergency
Hypertention Urgency/emergency
DIAGNOSED
Vital sign
value
Blood pressure
Pulse rate
66 bpm
Resp rate
20/min
Temperature
37C
spo2
98% RA
Reflomet
4.3mmol/L
So diagnosis as ???
DEFINITION
Hypertension is defined as persistent elevation of systolic BP of 140
mmHg or greater and/or diastolic BP of 90 mmHg or greater.
Hypertension is an increasingly important medical and public health
issue. The National Health and Morbidity Survey (NHMS) 2011 has
shown that the prevalence of hypertension in Malaysia for adults
18 years has increased from 32.2% in 2006 to 32.7%
in 2011. For those >30 years old, the prevalence has increased
from 42.6% to 43.5%
Unfortunately, 60.6% of total hypertensive were undiagnosed".
Hence BP should be measured at every opportunity.
CLASSIFICATION
MANAGEMENT
NONPHARMACOLOGIC
AL MANAGEMENT
MANAGEMENT
PHARMACOLOGIC
AL MANAGEMENT
NON-PHARMACOLOGICAL MANAGEMENT
Non-pharmacological management (therapeutic lifestyle
modification) plays an important role in the management of
hypertension and in improving overall cardiovascular health.
When recommending lifestyle modification, it is important to
know that these interventions require a concerted effort from both
the patient and the doctors.
NON-PHARMACOLOGICAL MANAGEMENT
WEIGHT REDUCTION
RELAXATION THERAPY
CESSATION OF SMOKING
HEALTHY EATING
REGULAR PHYSICAL EXERCISE
SODIUM INTAKE
AVOIDANCE OF ALCOHOL INTAKE
PHARMACOLOGICAL MANAGEMENT
GENERAL GUIDELINES
All patients must be risk stratified to guide management. Decision to
initiate pharmacologic treatment depends on the total
cardiovascular risk (Table 6). It is the reduction of BP which provides
the main benefits in the general hypertensive population. The choice
of drug should be individualized. Appendix 3 shows the drugs
currently available in Malaysia.
incidental finding in an
asymptomatic patient
non-specific symptoms like
headache, dizziness, lethargy
symptoms and signs of acute target
organ damage
SPECIFIC MANAGEMENT
The aim of management is to reduce BP in a controlled, predictable
and safe manner,in order to avoid the onset or aggravating acute
coronary syndrome, cerebral or renal ischaemia
value
Blood pressure
Pulse rate
66 bpm
Resp rate
20/min
Temperature
37C
spo2
98% RA
Reflomet
4.3mmol/L
Plan
Mx : t captopril 25mg stat
b/p monitoring every 15min
Cardiac monitoring
Cbd inserted strict i/o chart
Isoket 4ml/h
Target map 130
Refer medical......