文档介绍：Kieran McGlade Nov 2001 Department of General Practice QUB Aetiology of Hypertension ? Primary – 90-95% of cases – also termed “ essential ” of “ idiopathic ”? Secondary – about 5% of cases – Renal or renovascular disease – Endocrine disease ? Phaeochomocytoma ? Cusings syndrome ? Conn ’ s syndrome ? Acromegaly and hypothyroidism – Coarctation of the aorta – Iatrogenic ? Hormonal / oral contraceptive ? NSAIDs Kieran McGlade Nov 2001 Department of General Practice QUB This left ventricle is very thickened (slightly over 2 cm in thickness), but the rest of the heart is not greatly enlarged. This is typical for hypertensive heart disease. The hypertension creates a greater pressure load on the heart to induce the hypertrophy. Kieran McGlade Nov 2001 Department of General Practice QUB The left ventricle is markedly thickened in this patient with severe hypertension that was untreated for many years. The myocardial fibers have undergone hypertrophy. Kieran McGlade Nov 2001 Department of General Practice QUB H O T ? Hypertension Optimal Treatment ? Largest intervention trial in hypertension. Published in 1998 ? Conducted in General Practice. 18,790 patients in 26 countries ? Followed up for an average of years Kieran McGlade Nov 2001 Department of General Practice QUB H O T Findings ? Lowest incidence of major CV events occurred at a mean achieved DBP of 83 mmhg. This target (compared to mean achieved of 105 mmHg was associated with a 30% reduction in main CV events. ? In diabetes – Diastolic< or = 80mmhg 51 % lower pared to 90 mmHg Kieran McGlade Nov 2001 Department of General Practice QUB Global heart threat from diabetes: A global explosion in the number of cases of diabetes is threatening to reverse the reduction in deaths from heart disease in many western countries, including the United Kingdom. To coincide with World Diabetes Day on 14 November, Diabetes UK is calling for action to be taken to reduce the 20,000 deaths per ye