tailieunhanh - Cardiovascular Medicine Third Edition_3

Tham khảo sách 'cardiovascular medicine third edition_3', y tế - sức khoẻ, y học thường thức phục vụ nhu cầu học tập, nghiên cứu và làm việc hiệu quả | Hypertension Bernard Waeber Hans-Rudolph Brunner Michel Burnier and Jay N. Cohn Pathophysiology. 1833 Clinical Recognition. 1847 Natural History. 1850 Treatment. 1853 Summary. 1863 Hypertension is a common disease that contributes importantly to the high cardiovascular morbidity and mortality observed in industrialized countries. The proper diagnosis and management of this disorder affords considerable reduction of the risk of developing cardiac cerebral and renal complications. Approximately 95 of patients with high blood pressure exhibit the so-called essential or primary form of hypertension. Various mechanisms are involved in the pathogenesis of this type of hypertension. This heterogeneity accounts for the diverse therapeutic approaches that have been utilized and for the rationale for individualizing treatment programs. In a small fraction of patients the elevation of blood pressure is due to a specific cause secondary hypertension . The recognition of such patients has improved markedly in recent years. This is relevant since secondary hypertension can often be cured by appropriate interventions. The diagnosis of hypertension has been based entirely on the demonstration of a measured blood pressure above the normal range of values. Although this measurement clearly identifies individuals at an increased risk of developing morbid cardiovascular events the disease is not the blood pressure but rather is the vascular abnormality that results in these morbid events. Indeed morbid vascular events occur in many individuals whose blood pressures are within the normal range and many individuals with frankly elevated blood pressures do not experience morbid events. Consequently there is a growing sense that measured blood pressure is not by itself an adequate marker for the presence of the vascular disease that requires aggressive treatment. Efforts to develop methods to assess more specifically the blood vessels that are the site of abnormality in hypertension are .