HIPERTENSION ARTERIAL

KAREM A. MARTINEZ F.RESIDENTE ANESTESIOLOGIA Y REANIMACION HSB UNIVERSIDAD EL BOSQUE

Variables fenotipicas: ambiente/genotipo

Multifactorial Poligenico

EPIDEMIOLOGIA

Diagnostico primario mas frecuente 50 millones de personas en USA HTA esencial 90% Mayores de 55 años 90% de desarrollar

HTA

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

6

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.

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.

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.

TRATAMIENTO

Responsabilidad del juicio mèdico

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.

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

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.

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

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.

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.

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.

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