DOCSLIB.ORG

99 Hypertension with Complications and Secondary Hypertension

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
99 Hypertension with Complications and Secondary Hypertension H C Other maternal CCS categories: EXHIBIT 2.5 UP ANDFACTS FIGURES: STATISTICS 176 Contraceptive and procreative management (birth control Circulatory CCS categories: or helping with conception) 99 Hypertension with complications and secondary 177 Spontaneous abortion hypertension (high blood pressure with complications) 178 Induced abortion 100 Acute myocardial infarction (heart attack) 179 Postabortion complications (complications following 101 Coronary atherosclerosis (coronary artery disease) abortion) 102 Non-specific chest pain 180 Ectopic pregnancy (abdominal or tubal pregnancy) 106 Cardiac dysrhythmias (irregular heart beat) 181 Other complications of pregnancy 108 Congestive heart failure, nonhypertensive 182 Hemorrhage during pregnancy, abruptio placenta, 109 Acute cerebrovascular disease (stroke) O placenta previa (bleeding and placenta disorders N 110 Occlusion or stenosis of precerebral arteries (blockage of ho during pregnancy) arteries before brain) SPITA 186 Diabetes or abnormal glucose tolerance complicating 112 Transient cerebral ischemia (mini-stroke) L - B pregnancy, childbirth, or the puerperium (diabetes or high 114 Peripheral and visceral atherosclerosis (hardening of ASED CARE IN T blood glucose during pregnancy) arteries outside heart) 187 Malposition, malpresentation (breech birth and other 118 Phlebitis, thrombophlebitis, and thromboembolism disorders of baby’s position during birth) (inflammation and blood clots in the veins) 188 Obstructed labor or fetopelvic disproportion H 194 Forceps delivery Other circulatory CCS categories: E UNITED 2005 STATES, 195 Other maternal complications of birth, puerperium 96 Heart valve disorders affecting management of mother (other maternal 97 Peri-, endo-, and myocarditis, cardiomyopathy (disorders complications of birth and period after childbirth) of heart muscle and surrounding tissue, except that caused by tuberculosis or sexually transmitted disease) Infant CCS categories: 98 Essential hypertension (high blood pressure) 218 Liveborn (newborn infant) 103 Pulmonary heart disease (heart disease due to 219 Short gestation, low birth weight, and fetal growth lung disorders) retardation (premature birth and low birth weight) 104 Other and ill-defined heart disease 220 Intrauterine hypoxia and birth asphyxia (lack of oxygen to 105 Conduction disorders (disturbance of electrical activity baby in uterus or during birth) of heart) 221 Infant respiratory distress syndrome 107 Cardiac arrest and ventricular fibrillation (uncoordinated 222 Hemolytic jaundice and perinatal jaundice (infant jaundice contraction of heart) following birth) 111 Other and ill-defined cerebrovascular disease 223 Birth trauma (other blockage of brain blood supply) 224 Other perinatal conditions (other conditions occurring 113 Late effects of cerebrovascular disease (late effects of stroke) around the time of birth) 115 Aortic, peripheral, and visceral artery aneurysms (ballooning or rupture of an artery) Source: Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality 57.
Load more

Recommended publications
  • Hypertension: Putting the Pressure on the Silent Killer
    HYPERTENSION: PUTTING THE PRESSURE ON THE SILENT KILLER MAY 2016 TABLEHypertension: putting OF the CONTENTS pressure on the silent killer Table of contents UNDERSTANDING HYPERTENSION AND THE LINK TO CARDIOVASCULAR DISEASE 2 Understanding hypertension and the link to cardiovascular disease THEThe social SOCIAL and economic AND impact ECONOMIC of hypertension IMPACT OF HYPERTENSION 3 Diagnosing and treating hypertension – what is out there? DIAGNOSINGChallenges to tackling hypertension AND TREATING HYPERTENSION – WHAT IS OUT THERE? 6 Opportunities and focus areas for policymakers CHALLENGES TO TACKLING HYPERTENSION 9 OPPORTUNITIES AND FOCUS AREAS FOR POLICYMAKERS 15 HYPERTENSION: PUTTING THE PRESSURE ON THE SILENT KILLER UNDERSTANDING HYPERTENSION AND THE LINK TO CARDIOVASCULAR DISEASE Cardiovascular disease (CVD), or heart disease, is the number one cause of death in the world. 80% of deaths due to CVD occur in countries and poor communities where health systems are weak, and CVD accounts for nearly half of the estimated US$500 billion annual lost economic output associated with noncommunicable diseases (NCDs) in low-income and middle-income countries. In 2012, CVD killed 17.5 million people – the equivalent of every 3 in 10 deaths.1 Of these 17 million deaths a year, over half – 9.4 million - are caused by complications in hypertension, also commonly referred to as raised or high blood pressure2. Hypertension is a risk factor for coronary heart disease and the single most important risk factor for stroke - it is responsible for at least 45% of deaths due to heart disease, and at least 51% of deaths due to stroke. High blood pressure is defined as a systolic blood pressure at or above 140 mmHg and/or a diastolic blood pressure at or above 90 mmHg.
    [Show full text]
  • Hypertension and Coronary Heart Disease
    Journal of Human Hypertension (2002) 16 (Suppl 1), S61–S63 2002 Nature Publishing Group All rights reserved 0950-9240/02 $25.00 www.nature.com/jhh Hypertension and coronary heart disease E Escobar University of Chile, Santiago, Chile The association of hypertension and coronary heart atherosclerosis, damage of arterial territories other than disease is a frequent one. There are several patho- the coronary one, and of the extension and severity of physiologic mechanisms which link both diseases. coronary artery involvement. It is important to empha- Hypertension induces endothelial dysfunction, exacer- sise that complications and mortality of patients suffer- bates the atherosclerotic process and it contributes to ing a myocardial infarction are greater in hypertensive make the atherosclerotic plaque more unstable. Left patients. Treatment should be aimed to achieve optimal ventricular hypertrophy, which is the usual complication values of blood pressure, and all the strategies to treat of hypertension, promotes a decrease of ‘coronary coronary heart disease should be considered on an indi- reserve’ and increases myocardial oxygen demand, vidual basis. both mechanisms contributing to myocardial ischaemia. Journal of Human Hypertension (2002) 16 (Suppl 1), S61– From a clinical point of view hypertensive patients S63. DOI: 10.1038/sj/jhh/1001345 should have a complete evaluation of risk factors for Keywords: hypertension; hypertrophy; coronary heart disease There is a strong and frequent association between arterial hypertension.8 Hypertension is frequently arterial hypertension and coronary heart disease associated to metabolic disorders, such as insulin (CHD). In the PROCAM study, in men between 40 resistance with hyperinsulinaemia and dyslipidae- and 66 years of age, the prevalence of hypertension mia, which are additional risk factors of atheroscler- in patients who had a myocardial infarction was osis.9 14/1000 men in a follow-up of 4 years.
    [Show full text]
  • Hypertensive Emergency
    Presentation of hypertensive emergency Definitions surrounding hypertensive emergency Hypertension: elevated blood pressure (BP), usually defined as BP >140/90; pathological both in isolation and in association with other cardiovascular risk factors Severe hypertension: systolic BP (SBP) >200 mmHg and/or diastolic BP (DBP) >120 mmHg Hypertensive urgency: severe hypertension with no evidence of acute end organ damage Hypertensive emergency: severe hypertension with evidence of acute end organ damage Malignant/accelerated hypertension: a hypertensive emergency involving retinal vascular damage Causes of hypertensive emergency Usually inadequate treatment and/or poor compliance in known hypertension, the causes of which include: Essential hypertension o Age o Family history o Salt o Alcohol o Caffeine o Smoking o Obesity Secondary hypertension o Renal . Renal artery stenosis . Glomerulonephritis . Chonic pyelonephritis . Polycystic kidney disease o Endocrine . Cushing’s syndrome . Conn’s syndrome . Acromegaly . Hyperthyroidism . Phaeochromocytoma o Arterial . Coarctation of the aorta o Drugs . Alcohol . Cocaine . Amphetamines o Pregnancy . Pre-eclamplsia Pathophysiology of hypertensive emergency Abrupt rise in systemic vascular resistance Failure of normal autoregulatory mechanisms Fibrinoid necrosis of arterioles Damage to red blood cells from fibrin deposits causing microangiopathic haemolytic anaemia Microscopic haemorrhage Macroscopic haemorrhage Clinical features of hypertensive emergency Hypertensive encephalopathy o
    [Show full text]
  • Hypertension, Cholesterol, and Aspirin with Cost Info
    Diabetes & Your Health High Blood Pressure & Diabetes Aspirin & Did you know as many as two out of three adults with Heart Health diabetes have high blood pressure? High blood pressure Studies have shown is a serious problem. It can raise your chances of stroke, that taking a low- heart attack, eye problems, and kidney disease. dose aspirin every Many people do not know they have high blood pressure day can lower the because they do not have any symptoms. That is why it risk for heart attack is often called “the silent killer.” and stroke. The only way to know if you have high blood pressure is Aspirin can help to have it checked. If you have diabetes, you should those who are at high have your blood pressure checked every time you see risk of heart attack, the doctor. People with diabetes should try to keep their such as people who blood pressure lower than 130 over 80. have diabetes or high blood pressure. Cholesterol & Diabetes Aspirin can also help Keeping your cholesterol and other blood fats, called lipids, under control can people with diabetes help you prevent diabetes problems. Cholesterol and blood lipids that are too who have already high can lead to heart attack and stroke. Many people with diabetes have had a heart attack or problems with their cholesterol and other lipid levels. a stroke, or who have heart disease. You will not know that your cholesterol and blood lipids are at dangerous levels unless you have a blood test to have them checked. Everyone with diabetes Taking an aspirin a should have cholesterol and other lipid levels checked at least once per year.
    [Show full text]
  • Orthostatic Hypotension in a Cohort of Hypertensive Patients Referring to a Hypertension Clinic
    Journal of Human Hypertension (2015) 29, 599–603 © 2015 Macmillan Publishers Limited All rights reserved 0950-9240/15 www.nature.com/jhh ORIGINAL ARTICLE Orthostatic hypotension in a cohort of hypertensive patients referring to a hypertension clinic C Di Stefano, V Milazzo, S Totaro, G Sobrero, A Ravera, A Milan, S Maule and F Veglio The prevalence of orthostatic hypotension (OH) in hypertensive patients ranges from 3 to 26%. Drugs are a common cause of non-neurogenic OH. In the present study, we retrospectively evaluated the medical records of 9242 patients with essential hypertension referred to our Hypertension Unit. We analysed data on supine and standing blood pressure values, age, sex, severity of hypertension and therapeutic associations of drugs, commonly used in the treatment of hypertension. OH was present in 957 patients (10.4%). Drug combinations including α-blockers, centrally acting drugs, non-dihydropyridine calcium-channel blockers and diuretics were associated with OH. These pharmacological associations must be administered with caution, especially in hypertensive patients at high risk of OH (elderly or with severe and uncontrolled hypertension). Angiotensin-receptor blocker (ARB) seems to be not related with OH and may have a potential protective effect on the development of OH. Journal of Human Hypertension (2015) 29, 599–603; doi:10.1038/jhh.2014.130; published online 29 January 2015 INTRODUCTION stabilization, and then at 1 and 3 min after standing. The average of the Orthostatic hypotension (OH) is defined as the reduction in blood last two SBP and DBP values measured in the supine position and the pressure (BP) of at least 20 mmHg systolic and/or 10 mm Hg lowest value during standing were considered.
    [Show full text]
  • Hypertension and the Prothrombotic State
    Journal of Human Hypertension (2000) 14, 687–690 2000 Macmillan Publishers Ltd All rights reserved 0950-9240/00 $15.00 www.nature.com/jhh REVIEW ARTICLE Hypertension and the prothrombotic state GYH Lip Haemostasis Thrombosis and Vascular Biology Unit, University Department of Medicine, City Hospital, Birmingham, UK The basic underlying pathophysiological processes related to conventional risk factors, target organ dam- underlying the major complications of hypertension age, complications and long-term prognosis, as well as (that is, heart attacks and strokes) are thrombogenesis different antihypertensive treatments. Further work is and atherogenesis. Indeed, despite the blood vessels needed to examine the mechanisms leading to this being exposed to high pressures in hypertension, the phenomenon, the potential prognostic and treatment complications of hypertension are paradoxically throm- implications, and the possible value of measuring these botic in nature rather than haemorrhagic. The evidence parameters in routine clinical practice. suggests that hypertension appears to confer a Journal of Human Hypertension (2000) 14, 687–690 prothrombotic or hypercoagulable state, which can be Keywords: hypercoagulable; prothrombotic; coagulation; haemorheology; prognosis Introduction Indeed, patients with hypertension are well-recog- nised to demonstrate abnormalities of each of these Hypertension is well-recognised to be an important 1 components of Virchow’s triad, leading to a contributor to heart attacks and stroke. Further- prothrombotic or hypercoagulable state.4 Further- more, effective antihypertensive therapy reduces more, the processes of thrombogenesis and athero- strokes by 30–40%, and coronary artery disease by 2 genesis are intimately related, and many of the basic approximately 25%. Nevertheless the basic under- concepts thrombogenesis can be applied to athero- lying pathophysiological processes underlying both genesis.
    [Show full text]
  • Major Clinical Considerations for Secondary Hypertension And
    & Experim l e ca n i t in a l l C Journal of Clinical and Experimental C f a o r d l i a o Thevenard et al., J Clin Exp Cardiolog 2018, 9:11 n l o r g u y o Cardiology DOI: 10.4172/2155-9880.1000616 J ISSN: 2155-9880 Review Article Open Access Major Clinical Considerations for Secondary Hypertension and Treatment Challenges: Systematic Review Gabriela Thevenard1, Nathalia Bordin Dal-Prá1 and Idiberto José Zotarelli Filho2* 1Santa Casa de Misericordia Hospital, São Paulo, Brazil 2Department of scientific production, Street Ipiranga, São José do Rio Preto, São Paulo, Brazil *Corresponding author: Idiberto José Zotarelli Filho, Department of scientific production, Street Ipiranga, São José do Rio Preto, São Paulo, Brazil, Tel: +5517981666537; E-mail: [email protected] Received date: October 30, 2018; Accepted date: November 23, 2018; Published date: November 30, 2018 Copyright: ©2018 Thevenard G, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract Introduction: In this context, secondary arterial hypertension (SH) is defined as an increase in systemic arterial pressure (SAP) due to an identifiable cause. Only 5 to 10% of patients suffering from hypertension have a secondary form, while the vast majorities have essential hypertension. Objective: This study aimed to describe, through a systematic review, the main considerations on secondary hypertension, presenting its clinical data and main causes, as well as presenting the types of treatments according to the literary results.
    [Show full text]
  • How to Document and Code for Hypertensive Diseases in ICD-10 THIS INSTALLMENT in FPM’S ICD-10 SERIES EXPLAINS the GUIDELINES for CODING HYPERTENSION
    How to Document and Code for Hypertensive Diseases in ICD-10 THIS INSTALLMENT IN FPM’S ICD-10 SERIES EXPLAINS THE GUIDELINES FOR CODING HYPERTENSION. Kenneth D. Beckman, MD, MBA, CPE, CPC ecause ICD-10 can be a distressing topic, let’s start or kidney disease. That code is I10, Essential (primary) with some good news: Hypertension has a limited hypertension. number of ICD-10 codes – only nine codes for pri- As in ICD-9, this code includes “high blood pressure” mary hypertension and five codes for secondary but does not include elevated blood pressure without a B hypertension. This makes the task of coding hypertension diagnosis of hypertension (that would be ICD-10 code relatively simple – well, at least compared to some of the R03.0). If a patient has progressed from elevated blood other ICD-10 complexities. pressure to a formal diagnosis of hypertension, a good Another positive change in ICD-10 is that the new documentation practice would be to include the reason for code set drops the previous reference to benign and progressing the formal diagnosis. Similarly, a single mildly malignant hypertension. As physicians, we are well aware elevated blood pressure reading should be coded with the that hypertension is never truly “benign,” and the removal R03.0 until the formal diagnosis is established. of this antiquated term is a welcome improvement in the Although various sources define hypertension slightly lexicon of diseases. differently, the provider should document elevated systolic But, of course, nothing is easy in ICD-10, and there are pressure above 140 or diastolic pressure above 90 with at several things you need to be aware of before we dig into least two readings on separate office visits.
    [Show full text]
  • Pulmonary Hypertension ______
    Pulmonary Hypertension _________________________________________ What is it? High blood pressure in the arteries that supply the lungs is called pulmonary hypertension (PH) or pulmonary arterial hypertension (PAH). The blood pressure measured by a cuff on your arm isn’t directly related to the pressure in your lungs. The blood vessels that supply the lungs constrict and their walls thicken, so they can’t carry as much blood. As in a kinked garden hose, pressure builds up and backs up. The heart works harder, trying to force the blood through. If the pressure is high enough, eventually the heart can’t keep up, and less blood can circulate through the lungs to pick up oxygen. Patients then become tired, dizzy and short of breath. If a pre-existing disease triggered the PH, doctors call it secondary pulmonary hypertension. That’s because it’s secondary to another problem, such as a left heart or lung disorder. However, congenital heart disease can cause PH that’s similar to PH when the cause isn’t known, i.e., idiopathic or unexplained pulmonary arterial hypertension. In this case, the PAH is considered pulmonary arterial hypertension associated with congenital heart disease, such as associated with a VSD or ASD (either repaired or unrepaired). The problem is due to scarring in the small arteries in the lung. It’s important to repair congenital heart problems (when possible) before permanent pulmonary hypertensive changes develop. Intracardiac left-to-right shunts (such as a ventricular or atrial septal defect, a hole in the wall between the two ventricles or atria) can cause too much blood flow through the lungs.
    [Show full text]
  • Uncontrolled Hypertension and Associated Factors Among Hypertensive Adults in Bale Zone Public Hospitals, Ethiopia Feyissa Lemessa1* and Miressa Lamessa2
    ISSN: 2474-3690 Lemessa and Lemessa. J Hypertens Manag 2021, 7:057 DOI: 10.23937/2474-3690/1510057 Volume 7 | Issue 1 Journal of Open Access Hypertension and Management ORIGINAL RESEARCH Uncontrolled Hypertension and Associated Factors among Hypertensive Adults in Bale Zone Public Hospitals, Ethiopia Feyissa Lemessa1* and Miressa Lamessa2 1 Department of Nursing, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia Check for 2Department of Emergency and Critical Care, St. Paul’s Hospital Millennium Medical College, Addis Ababa, updates Ethiopia *Corresponding author: Feyissa Lemessa Jinfessa, Department of Nursing, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia, Tel : +251-920-405-878 Abstract Conclusion: The prevalence of uncontrolled hypertension was high at the study area among patients with hyperten- Background: Although blood pressure control has tremen- sion. Being overweight and lack of awareness on Hyperten- dous public health benefit, and has effective treatments, the sion i.e. poor knowledge on hypertension management can global rate of uncontrolled blood pressure remains high. In result in hypertension-related complications. Hence, Con- sub-Saharan Africa including Ethiopia uncontrolled blood tinuous health education on lifestyle practices and hyper- pressure resulted in a significant morbidity and mortality. tension-related complications in each follow-up visit highly Unfortunately, uncontrolled hypertension among adult hy- recommended. pertensive patients remains unclear and has been inade- quately studied in Ethiopia, in the study area in particular. Keywords Objective of the study: This study assessed uncontrolled Uncontrolled hypertension, Self-care practice, Bale, Ethiopia hypertension and associated factors among adult hyperten- sive patients on follow up clinics in Bale Zone Public Hospi- tals, Ethiopia, 2017.
    [Show full text]
  • Chapter 13. Secondary Hypertension
    Hypertension Research (2014) 37, 349–361 & 2014 The Japanese Society of Hypertension All rights reserved 0916-9636/14 www.nature.com/hr GUIDELINES (JSH 2014) Chapter 13. Secondary hypertension Hypertension Research (2014) 37, 349–361; doi:10.1038/hr.2014.16 OVERVIEW AND SCREENING approximately 5–10% of hypertensive patients,984,985 and it is the most Hypertension related to a specific etiology is termed secondary frequent in endocrine hypertension. In addition, frequent etiological hypertension, markedly differing from essential hypertension, of factors for secondary hypertension include renal parenchymal hyper- which the etiology cannot be identified, in the condition and tension and renovascular hypertension. A study reported that sleep therapeutic strategies. Secondary hypertension is often resistant hyper- apnea syndrome was the most frequent factor for secondary hyper- tension, for which a target blood pressure is difficult to achieve by tension.517 The number of patients with secondary hypertension standard treatment. However, blood pressure can be effectively may further increase with the widespread diagnosis of sleep apnea reduced by identifying its etiology and treating the condition. There- syndrome. fore, it is important to suspect secondary hypertension and reach an Generally, the presence of severe or resistant hypertension, juvenile appropriate diagnosis. hypertension and the rapid onset of hypertension suggest the possi- Frequent etiological factors for secondary hypertension include bility of secondary hypertension. In such hypertensive patients, a close renal parenchymal hypertension, primary aldosteronism (PA), reno- inquiry on medical history, medical examination and adequate vascular hypertension and sleep apnea syndrome. Renal parenchymal examinations must be performed, considering the possibility of hypertension is caused by glomerular diseases, such as chronic secondary hypertension.
    [Show full text]
  • Hypertension and Hypotension
    19/06/2018 Hypertension • Definitions: • WHO 140/90 • Westmead: calling criteria Hypertension and • If untreated 50% die of cardiovascular disease • 33% get a stroke Hypotension • 10% will develop renal failure Dr Giles Miller Hypertension • Causes • Essential • Renal • Endocrine • Neurogenic • Psychogenic • Miscellaneous 1 19/06/2018 Hypertension Hypertension treatments • Patterns • GTN patch • Hyperdynamic • Hydralazine • Vasoconstricted • B‐blockers • End Organ Damage • Ca channel • Cardiac • Diuretics • Eyes • ACEI • Renal • Angiotensin II blockers • Cerebral • Central acting alpha agonists Case Studies ‐ 1 Case 1 Needs to be reviewed but not a high priority • 78 yr old male • Past History • Admitted with UTI and delirium. Normally lives at home with • Mild dementia daughter as carer. • Hypertension ‐ Normally well controlled with BP 130/80 • Chronic renal failure (Cr 180) Always check the Medications! • Nurse calls you BP 168/92 at 10am on sat morning. • Medications • Diuretics, ACEI. • What are you going to do? • Missed daily dose of antiHT. 2 19/06/2018 Case Studies ‐ 2 Case 2 • Usual BP 150/90. • 56yr old lady with ESRF • On multiple antiHT • Dialysis 3 times a week via left AVF • ‐metoprolol, felodipine. • Had been drinking more recently due to some hot weather. Went • Nurse calls as BP prior to dialysis is 210/100 over usual fluid restriction. Weight up by 5kg You would always check with the renal physician/med reg first • What are you going to do? • Prazocin would be a typical drug to use in this circumstance Case Studies ‐ 3 Case 3 • Pre‐eclampsia definition: SBP >140, DBP >90 with renal involvement • Pregnant lady, 34 weeks. causing proteinuria.
    [Show full text]