项目健康教育课堂神内-培训课件.ppt

首先来看看血压的定义，血压，顾名思义，就是血管内的血液对于单位面积血管壁的侧压力。当心脏收缩时，大动脉内产生的压力叫收缩压，也就是通常所说的高压。相反，当心脏舒张时，大动脉的弹性回缩产生的压力叫舒张压，也就是通常所说的低压。 高血压患者常见头晕、头痛、颈项板紧、疲劳、心悸、视力模糊、鼻出血等临床表现，但也有些患者没有临床表现，只是血压升高，因此血压应经常监测。 在我国，高血压的患病率高达18.8%，即每5个成年人就有1人为高血压。 但是，这些高血压患者只有30.2%知道自己得了高血压，24.7%接受治疗，仅有6.1%把血压控制在正常水平。 在未使用降压药物的情况下，非同日3次测量血压，SBP≥140 mm Hg和(或)DBP≥90 mmHg。SBP≥140 mm Hg和DBP90 mmHg为单纯性收缩期高血压。患者既往有高血压史，目前正在使用降压药物，血压虽然低于140／90 mm Hg，也诊断为高血压。 Types of Morning Hypertension For patients with high BP, this circadian pattern is no different but may be associated with poor health outcomes. In patients with hypertension, BP follows a nadir occurring during the nighttime hours and a surge occurring during the early morning period (6 AM-12 PM). This phenomenon is referred to as morning hypertension. Two types of morning hypertension exist. Patients who demonstrate persistently high BP from nighttime to morning are referred to as nondippers, as their BP remains elevated nocturnally. The second type is morning surge hypertension (MSH), which is associated in part with the extreme dips of nocturnal BP. For these hypertensive patients, their nighttime BP is 20% lower than their daytime BP. 1.Hoshide S, Kario K, Hoshide Y, et al. Associations between nondipping of nocturnal blood pressure decrease and cardiovascular target organ damage in strictly selected community-dwelling normotensives. Am J Hypertens. 2003;16:434-438. 2.Kario K, Yasui N, Yokoi H. Ambulatory blood pressure monitoring for cardiovascular medicine. IEEE Eng Med Biol Mag. 2003;22:81-88. 3.Kario K, Shimada K, Pickering TG. Abnormal nocturnal blood pressure falls in elderly hypertension: clinical significance and determinants. J Cardiovasc Pharmacol. 2003;41 Suppl 1:S61-66. 血压水平升高后，会导致心、脑、肾还有其他动脉的病变，所以要做好高血压的防治 在2010年的中国高血压防治指南中指出，普通高血压患者应把血压控制在140/90mmHg，糖尿病和肾病患者应把血压控制在130/80mmHg,65岁及以上的老年人应把血压控制在150/90mmHg 指南推荐一线的降压药物，根据作用机制不同分为五类：钙离子拮抗剂、血管紧张素转换酶抑制剂、血管紧张素II受体拮抗剂、利尿剂和β-受体阻滞剂， 首先我们要明确血脂异常的定义 临床常根据脂蛋白的密度和直径大小分类，可分为：极低密度脂蛋白胆固醇、中间密度脂蛋白胆固醇、低密度脂蛋白胆固