Hypertensie
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| Hypertensie,definitie | Te hoge arterële bloeddruk SBD>140 en/of DBD>90mmHg
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| Geisoleerde systolische hypertensie | SBD>140, DBD gb
- Ouderen->artheroscleorse->vaatbreedte↓->polsdruk verbreedt,SBD stijgt>DBD
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| Witte jas hypertensie | Agv angst/stress voor arts hypertensie. Thuis laten meten.
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| Hypertensie vaststellen, protocol | -Zittend
-Na enkele min rust
-Geijkte manometer
-Manchet t.h.v. sternum
-Niet spreken
-2 maal, tussenpozen 15 sec, zelfde arm->gem
-1e consult beide armen, verschil 10 mmHg->volgende consult die arm
-SBD>140 =2e consult:>10↑->3e consult:gem=risico
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| Classificatie bloeddruk | ...SBD DBD
Optimaal <120 & <80
Normaal 120-129 &/ <85
Hoog/normaal 130-139 &/ 85-89
Hypertensie
GradeI 140-159 &/ 90-99
GradeII 160-179 &/ 100-109
GradeIII >180, >109
Geisoleerde systolische hypertensie
GradeI 140-149, <90
GradeII >160, <90
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| Oorzaken essentiële hypertensie | -Genetisch, familiair
-laag geboortegewicht
-Obesitas
-Alcohol (veel verhoogd, laag verlaagd)
-natrium inname
-Stress
-Diabetes
-Metabool syndroom
-Renale Na uitscheiding↓(normale Pa)(RAAS, natriuretisch pept.)
-func vasocon(kalikrein-kinine sy
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| Oorzaken secundaire hypertensie | -Renaal:diab.NP,chr GN,adult polycystic,chr TIN,renovasc
-Endo:Crohn,adrenale hyperplasie,phaeochromocytomie,Cushing,acromegalie
-Cong:coarctatio aortae
-Med:NSAIDs,orale contracep,stero,carbenoxolone,liquorice,symp.metica,vasopres
Zwanger,cardiovasc
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| Complicaties hypertensie | Cerebrovasculaire ziekte\
Coronaire art.aand. \-->vnl oorzaak dood
nierfalen
perifere vaatziekten
6x meer kans beroerte
3x meer kans cardiale dood
2x meer kans perifere vaatziekten
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