1、高血壓1.anatomy2.3.Pathogenesis of HypertensionHereditary and gene hypothesis20-40% population have hereditary tendency 4.Environmental factorsOver weight high salt diet drunk5.Pathophysiology of Hypertension BP=CO X SVRCO: cardiac outputblood volume，HR， myocardial contractilitySVR：systolic volume rati

2、oarteriole structure Compliance of Vessel wall6.Psychological factorsRenin angiotensin aldosterone system（RAAS）Sodium and hypertensionAbnormality of vascular endothelium（ET，NO，AngII, PGI2, etc)Insulin resistancerevascularizationother（obesity，smoking，drinking，hypocalcium, hypomagnesium, hypopotassium

3、）7.Clinical ManifestationEarly symptom: great BP variation headache，dizziness，palpitation， fatigueLate symptom: manifestation of complications brain, heart，eye, kidney, vessel damage8.DiagnosisSBP140mmHg and /or DBP 90mmHg2 or more than twice not in the same day under non pharmacological condition9.

4、classifySBP（mmHg)DBP (mmHg)Idea BP 120 80Regular BP 130 = 180 = 110注：當(dāng)收縮壓與舒張壓屬不同級(jí)別時(shí)，應(yīng)該取較高的級(jí)別分類。10.Risk stratification of CV disease 血壓（mmHg) 其他危險(xiǎn)因素 D1 D 2D3 和病史 I 無(wú)其他危險(xiǎn)因素 LRG MRG HRG II 1-2個(gè)危險(xiǎn)因素 MRG MRGEHRG III 3個(gè)危險(xiǎn)因素 或靶器官損害 HRG HRGEHRG 或糖尿病 IV 并存臨床情況 EHRG EHRG EHRG 11.Clinical Evaluation of hyperte

5、nsionEvaluation of BP levelExclusion secondary hypertensionEvaluation of target organ damage Other cardiovascular risk factors and other clinical condition to effect on prognosis12.Risk factor of cardiovascular diseasemale 55, female 65smokingTotal cholesterol 5.72mmol/L (250mg/dl)diabetesEarly card

6、iovascular family history（early onset of CV diseasemale55；female 65)13. Non-medication treatment BMI(Kg/m2)=24BP drops 5-20 points with 10 kg wt lossLifestyle Modifications to Lower Blood Pressure Reduce sodium intake ：6greduce fat intake：less than 30% of totaleat more greens and dairy productsrestric alcohol intake：177mmol/L 或2.0mg/dL)心臟疾病心肌梗死心絞痛冠狀動(dòng)脈血運(yùn)重建 (PTCA,PCI,CABG)