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##Lecture HPT 1 Okt 2013 Update Today !-10-2014
##Lecture HPT 1 Okt 2013 Update Today !-10-2014
Sahala Panggabean
BAGIAN
BAGIAN
ILMU
ILMU PENYAKIT
PENYAKIT DALAM
DALAM
FKUKI
FKUKI
Jakarta,
Jakarta, 11 Oktober
Oktober 2014
2014
PATOFISIOLOGI HIPERTENSI
Autoregulation
Constriction hypertrophy
Fluid Volume
Volume Redistribution
Sympathetic Renin- Cell Hyper
nervous over- Angiostensin Membran Insulinemia
Renal Decreased activity Excess Alteration
Sodium filtration
Retension surface
Stress Obesity
Medical history
Physical examination
Routine laboratory tests
Optional tests
MEDICAL HISTORY
Duration and classification of hypertension
Patient history of cardiovascular disease
Family history
Symptoms suggesting causes of
hypertension
Lifestyle factors
Current and previous medications
Physical Examination
Urinalysis
Complete blood count
Blood chemistry (potassium, sodium,
creatinine, and fasting glucose)
Lipid profile (total cholesterol and HDL
cholesterol)
12-lead electrocardiogram
Optional Tests and Procedures
Heart diseases
Stroke or transient ischemic attack
Nephropathy
Peripheral arterial disease
Retinopathy
Types of Hypertension
Primary HTN:
also known as essential HTN.
accounts for 95% cases of HTN.
no universally established cause known.
Secondary HTN:
less common cause of HTN ( 5%).
secondary to other potentially rectifiable causes
Causes of Secondary HTN
Common
Intrinsic renal disease
Renovascular disease
Mineralocorticoid excess
Sleep Breathing disorder
Risk Stratification
Demographics
Coexisting diseases and Therapies
Quality of life
Physiological and biochemical measurements
Drug interactions
Economic considerations
Drug Therapy
Optimize dosages or add additional drugs until goal blood pressure is achieved. Consider
consultation with hypertension specialist