Hypertension

• Patient assessment- brief overview

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• Guidelines
• New Zealand Guidelines: Threshold for Pharmacologic Treatment
• New Zealand Guidelines: Emerging Risk Factors
• Selected Information From JNC 7

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• Left Ventricular Hypertrophy
• LVH on ECG and prognosis
• LVH with echo and prognosis
• Africans have more LVH
• LVH- more information

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• Hypertension Trials
• Beta-blockers no longer first or second line agents for treatment of hypertension for all patients.
• Review of Hypertension trials- 2005
• ASCOT, LIFE, ALLHAT, ANBP2

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• Ambulatory and Home BP Monitoring
• Introduction

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• Lifestyle Measures
• Impact on Hypertension

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• Resistant Hypertension
• Meet the experts session- ESC 2008

Hypertension- Impact of Lifestyle Measures

Lifestyle modifications in hypertension
Modification	Recommendation	Approximate range of systolic BP reduction
Weight reduction	Maintain normal body weight (BMI 18.5–24.9)	5–20 mm Hg/10-kg weight loss
Adopt DASH diet eating plan	Consume a diet rich in fruits, vegetables, and low-fat dairy products with a reduced content of saturated and total fat	8–14 mm Hg
Dietary sodium reduction	Reduce dietary sodium intake to no more than 100 mEq/L (2.4 g sodium or 6 g sodium chloride)	2–8 mmHg
Physical activity	Engage in regular aerobic physical activity such as brisk walking (at least 30 minutes per day, most days of the week)	4–9 mmHg
Moderation of alcohol consumption	Limit consumption to no more than 2 drinks per day in most men and no more than 1 drink per day in women and lighter-weight persons	2–4 mmHg

Hitesh Patel, Cardiologist

5th May, 2005

Reference:
Franco V et al. Review: Clinical Cardiology: New Frontiers. Hypertensive Therapy: Part I.Circulation. 2004;109:2953-2958.