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HIPERTENSION ARTERIAL
KAREM A. MARTINEZ F.RESIDENTE ANESTESIOLOGIA Y REANIMACION HSB UNIVERSIDAD EL BOSQUE
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Variables fenotipicas: ambiente/genotipo
Multifactorial Poligenico
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EPIDEMIOLOGIA
Diagnostico primario mas frecuente 50 millones de personas en USA HTA esencial 90% Mayores de 55 años 90% de desarrollar
HTA
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RIESGO DE ENFEREMEDAD CARDIOVASCULAR
Relacion presion arterial/ECV continua Incremento de 20/10 mmHg, dobla
riesgo Mayor posibilidad de:1. IAM2. Insuficiencia cardiaca3. Enfermedad renal4. Evento cerebro vascular
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Hypertension. Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Aram V. Chobanian, George L. Bakris, Henry R. Black, William C. Cushman, Lee A. Green. 2003 AHA.
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Hypertension. Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Aram V. Chobanian, George L. Bakris, Henry R. Black, William C. Cushman, Lee A. Green. 2003 AHA.
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Hypertension. Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Aram V. Chobanian, George L. Bakris, Henry R. Black, William C. Cushman, Lee A. Green. 2003 AHA.
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TRATAMIENTO
Responsabilidad del juicio mèdico
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Manejo antihipert
ensivo
35-40% reduccion
Eventos cerebro vasculares
50% Insuficiencia cardiaca
20-25% IAM
Hypertension. Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Aram V. Chobanian, George L. Bakris, Henry R. Black, William C. Cushman, Lee A. Green. 2003 AHA.
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OBJETIVOS
Reduccion de la morbi-mortalidad Adoptar estilos de vida saludables Bajar de peso Ingesta de potasio y calcio Disminuir ingesta de sodio Actividad fisica Disminuir TA 140/90 mmHg Diabeticos y E. Renal TA: 130/80
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Hypertension. Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Aram V. Chobanian, George L. Bakris, Henry R. Black, William C. Cushman, Lee A. Green. 2003 AHA.
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Diureticos Tiazidicos base de terapia antihipertensiva en la mayoria de los estudios
Ante intolerancia o contraindicacion se continuara otro que haya demostrado reduccion en ECV
Adicion 2do farmaco cuando la monoterapia a dosis adecuada falla
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Hypertension. Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Aram V. Chobanian, George L. Bakris, Henry R. Black, William C. Cushman, Lee A. Green. 2003 AHA.
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Hypertension. Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Aram V. Chobanian, George L. Bakris, Henry R. Black, William C. Cushman, Lee A. Green. 2003 AHA.
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Hypertension. Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Aram V. Chobanian, George L. Bakris, Henry R. Black, William C. Cushman, Lee A. Green. 2003 AHA.
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1. Hypertension. Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Aram V. Chobanian, George L. Bakris, Henry R. Black, William C. Cushman, Lee A. Green. 2003 AHA.
BIBLIOGRAFIA