MindMap Gallery essential hypertension
This is a mind map about essential hypertension, including principles, Definition, etiology and pathogenesis, clinical manifestations, Experimental inspection, Diagnostic points, etc.
Edited at 2024-04-05 15:31:38Ce calendrier annuel, créé avec EdrawMax, présente une disposition claire et organisée des mois de janvier à décembre. Chaque mois est affiché dans un cadre distinct, montrant les jours de la semaine et les dates correspondantes. Les weekends (samedis et dimanches) sont mis en évidence pour une meilleure visibilité. Ce format est idéal pour la planification et l'organisation des activités tout au long de l'année, offrant une vue d'ensemble rapide et facile à consulter.
This quarterly calendar overview for 2026, created with EdrawMax, presents a structured and colorful layout of the entire year divided into four quarters. Each quarter is displayed in a separate column, showcasing the months within that quarter in a clear grid format. The days of the week are labeled, and each date is marked within its respective cell, allowing for easy identification of dates across the year. This calendar is an excellent tool for long-term planning, providing a comprehensive view of the year at a glance.
This weekly calendar for 2026 is designed using EdrawMax to provide a detailed and organized view of each week, starting from January. The left side features a mini monthly calendar for quick reference, highlighting the current week in yellow. Below it, there's a section for weekly goals to help prioritize tasks. The main area is a time-grid from 6:00 AM to 12:00 AM, divided into half-hour slots, allowing for precise scheduling of daily activities throughout the week. This layout is ideal for managing a busy schedule efficiently.
Ce calendrier annuel, créé avec EdrawMax, présente une disposition claire et organisée des mois de janvier à décembre. Chaque mois est affiché dans un cadre distinct, montrant les jours de la semaine et les dates correspondantes. Les weekends (samedis et dimanches) sont mis en évidence pour une meilleure visibilité. Ce format est idéal pour la planification et l'organisation des activités tout au long de l'année, offrant une vue d'ensemble rapide et facile à consulter.
This quarterly calendar overview for 2026, created with EdrawMax, presents a structured and colorful layout of the entire year divided into four quarters. Each quarter is displayed in a separate column, showcasing the months within that quarter in a clear grid format. The days of the week are labeled, and each date is marked within its respective cell, allowing for easy identification of dates across the year. This calendar is an excellent tool for long-term planning, providing a comprehensive view of the year at a glance.
This weekly calendar for 2026 is designed using EdrawMax to provide a detailed and organized view of each week, starting from January. The left side features a mini monthly calendar for quick reference, highlighting the current week in yellow. Below it, there's a section for weekly goals to help prioritize tasks. The main area is a time-grid from 6:00 AM to 12:00 AM, divided into half-hour slots, allowing for precise scheduling of daily activities throughout the week. This layout is ideal for managing a busy schedule efficiently.
Section 8 Essential Hypertension
principle
hypertension
→Sympathetic nerve excitement
B-blockers (....Lol)
→HR↑, myocardial contractility↑
→cap shrink
→renin release
→Renin-angiotensin-aldosterone system (RAAS) activation
→renin
→Angiotensin I
→Angiotensin II
→Angiotensin-converting enzyme
ARB (...sartan)
→Aldosterone↑
→cap shrink
→Renal water and sodium retention
diuretics
→cap mechanism
(Smoking) → Endothelial cell damage
→cap active substance↑
→cap shrink
calcium channel blockers
→insulin resistance
→Renal water and sodium retention
diuretics
hypertension
→Endothelial cell damage
→cap permeability↑ Plasma proteins leak out of cap wall
→A hardening
→Heart burden↑
→Myocardial hypertrophy
→Heart failure
→Cerebral A sclerosis
→Cerebral ischemia (acid product↑) cap permeability↑
→Cerebral edema
→Cerebral hemorrhage
→Glomerular afferent arteriole sclerosis
The glomerular afferent arteriole is thicker than the efferent arteriole → blood flows slowly in the glomerulus → facilitates filtration Hypertension → glomerular A sclerosis (afferent arteriole > efferent arteriole...) → glomerular blood flow↓
→Glomerular ischemia, fibrosis, and atrophy
→The unaffected lung compensates (hyperplasia)
→Kidney atrophy and uneven surface
→Retinal vascular sclerosis
→Hemorrhage, edema
definition
Systemic arterial pressure↑
Cause and pathogenesis
Cause
genetics
environment
diet
High sodium, low potassium, low calcium
high protein
→Protein exudation↑→A hardening↑ →Kidney burden
saturated fatty acid
drinking
folate deficiency
↓Homocysteine
mental stimulation
smoking
other
overweight, obesity
Oral contraceptives, ephedrine, corticosteroids
Ephedrine: cap contraction (treating nasal congestion)
Diabetes, dyslipidemia
Pathogenesis
neural mechanism
kidney mechanism
Hormone mechanism
vascular mechanism
Insulin resistance
clinical manifestations
general performance
Slow onset, no special symptoms General and physical examination findings
hypertensive emergency
Distinguish 1
hypertensive emergency
Blood pressure suddenly ↑180/120mmHg or above, indicating functional insufficiency
Hypertensive emergency
Sudden blood pressure, no insufficiency
Distinguish 2
Hypertensive encephalopathy
Cerebellar A has persistent and severe spasms that exceed the brain's ability to regulate. Causes cerebral edema and intracranial pressure ↑ brain dysfunction
Manifestations (brain manifestations): severe headache, vomiting, disturbance of consciousness, confusion, and even coma
hypertensive crisis
The surrounding small A temporarily contracts strongly, causing the blood pressure to ↑↑↑,
Restlessness, headache, dizziness, palpitations, shortness of breath, blurred vision
malignant hypertension
Diastolic blood pressure ≥130mmHg, accompanied by headache, blurred vision, fundus bleeding, Exudation or even edema, prominent kidney damage, persistent proteinuria, and hematuria
complication (Heart brain kidney eye cap)
cerebrovascular disease
heart failure, coronary heart disease
Left ventricular afterload↑
chronic renal failure
aortic dissection
Sudden tearing chest pain
Coronary heart disease: squeezing pain
Retinopathy
laboratory tests
Diagnostic points
diagnosis
① Not taking antihypertensive drugs, systolic blood pressure ≥140mmHg, systolic blood pressure ≥90mmHg three times on different days.
②Have a history of hypertension and are taking decompression drugs. Although the blood pressure is <140/90mmHg, hypertension can still be diagnosed
Classification
When systolic blood pressure and diastolic blood pressure belong to different levels, the higher level will be used as the standard.
systolic blood pressure
diastolic blood pressure
normal high value
120-130
80-89
Grade 1 hypertension (mild)
140-159
90-99
Grade 2 hypertension (moderate)
160-179
100-109
Grade 3 hypertension (severe)
≥180
≥110
Cardiovascular level stratification criteria for patients with hypertension
Grade 3 hypertension, comorbid diabetes, clinical complications: very high risk
Grade 1 hypertension
level 2...
Grade 3 hypertension
1-2 risk factors
medium risk
medium risk
Very high risk
≥3 risk factors target organ damage uncomplicated diabetes
high risk
high risk
Very high risk
clinical complications diabetes with complications
Very high risk
Very high risk
Very high risk
Treatment points
Purpose
Minimize the occurrence of cardiovascular and cerebrovascular complications and death
①General patients: below 140/90
②Elderly people: 150/90
Sclerosis in the elderly: hypotension → cerebral ischemia
③Diabetes and kidney disease: 130/80
Tang Monk Sanba
non-pharmacological treatment (life intervention)
①Control weight
②↓Sodium salt ↑K, calcium
③↓Fat
④ Quit smoking and limit alcohol consumption
⑤Increase exercise
⑥↓Mental stress and maintaining psychological balance
⑦Supplement folic acid preparations when necessary
medical treatement
opportunity
① High risk, very high risk: start anti-stress medication immediately
②Medium risk and low risk: life intervention, follow-up for 1 month and 3 months; if multiple measurements are still higher than 140/90, start antihypertensive treatment
drug
diuretics
Function: sodium excretion, ↓ blood volume, ↓ peripheral resistance
Indications: Mild to moderate hypertension
Precautions
Disabled for gout
Thiazides, furosemide (furosemide): hypokalemia
B receptor antagonist
non-pharmacological treatment (life intervention)
①Control weight
②↓Sodium salt ↑K, calcium
③↓Fat
④ Quit smoking and limit alcohol consumption
⑤Increase exercise
⑥↓Mental stress and maintaining psychological balance
⑦Supplement folic acid preparations when necessary
Function: Inhibits sympathetic nerves, ↓ myocardial contractility, ↓ heart rate
Indications: Young and middle-aged people with fast heart rate Combined with angina pectoris and chronic heart failure
Contraindications
Bradycardia, sick sinus syndrome Atrioventricular block, asthma, copd
Calcium channel blocker CCB
Function: Block calcium ion channels on cap smooth muscle and dilate blood vessels
Indications: Hypertensive patients with coronary heart disease and diabetes
Adverse reactions: facial flushing, pretibial edema
ACEI
Indications: combined with heart failure, myocardial infarction, diabetes, kidney disease (proteinuria)
ACEI protects heart, kidneys and blood sugar
Contraindications: hyperkalemia, pregnancy, renal A stenosis
Adverse reactions: irritating dry cough
ARB
Medication principles
small intestine fusion long
Start with a small dose
Prefer long-acting preparations
Combination medication
individualize
Treatment of hypertensive emergencies
Processing principles
①Instant blood pressure reduction
②Controlled blood pressure reduction
Initial phase: no more than 25% of previous level
It will reach the safe range (160/100) in 2-6 hours
It will gradually return to normal levels within 24-48 hours.
③Choose antihypertensive drugs rationally
④Drugs to avoid
Avoid reserpine and strong diuretics
→Malignant hypotension
care
① Absolute bed rest
②Complicated acute left heart failure: high-flow oxygen inhalation
③The head of a comatose patient turns to one side
④Irritable/convulsive patients: bed rails
Stress Relief Drug Selection
Sodium nitroprusside (preferred)
Mechanism: dilation of arteries and veins→cardiac preload and postload↓
① Measure blood pressure every 5-10 minutes
Lowering blood pressure too much
②Adverse reactions: nausea, vomiting, muscle tremors
③ Not suitable for long-term use in large doses → hydrogen sulfate poisoning
④Contraindicated for renal insufficiency
Nitroglycerin
Mechanism: Selective dilation of arteries
Adverse reactions: bradycardia, flushing, headache, vomiting
Hypertensive emergency
24-48h approaching 160/100
nursing assessment
nursing issues
Pain: headache
Risk of injury associated with dizziness, blurred vision, altered consciousness, or orthostatic hypotension
Potential complications: Hypertensive emergency
Nursing measures
Headache
① Reduce the causes that cause or aggravate headaches
Comfortable environment, reduced visits and avoid negative factors
Elevate the head of the bed (↓ cerebral edema)
② Medication and care
Risk of injury
① Avoid injury
②Orthostatic hypotension
a. Special attention should be paid when taking the first dose or increasing the dosage.
b. Prevention
Avoid standing for long periods of time, moving slowly, Rest for a period of time after taking the medicine, and do not drink a lot of alcohol
c. Treatment measures
Lying on your back and raising your lower limbs to promote
Complications: Hypertensive emergency
health education
dietary guidance
①Control weight
②↓Sodium salt ↑K, calcium
③↓Fat
④ Quit smoking and limit alcohol consumption
⑤Increase exercise
⑥↓Mental stress and maintaining psychological balance
⑦Supplement folic acid preparations when necessary
Proper exercise
Control weight: BMI<24
4-7 days per week, moderate exercise involving 30-60 degrees to reach maximum heart rate
Maximum heart rate=220-age
avoid triggers
①Avoid emotional excitement
② Cold stimulation can constrict blood vessels and increase blood pressure. The room temperature should not be too low.
③ Have smooth bowel movements and avoid coughing forcefully to prevent cerebrovascular accidents
④Avoid sudden changes in body position and prohibit standing for long periods of time
⑤Do not take a bath with overheated water
home blood pressure monitoring
Blood pressure is not up to standard
Once a day in the morning and evening, 2-3 times each time, for 7 consecutive days
People with blood pressure up to standard
1 time a week
Regular follow-up
Those who do not meet the target: once every 2-4 weeks
Those who meet the standard: once every 3 months