Pathophysiology of Hypertension BPECO X SVR CO: blood volume, HR, myocardial contractility SVR:阻力小动脉结构改变 血管壁顺应性降低 血管的舒缩状态改变
Pathophysiology of Hypertension • BP=CO X SVR • CO: blood volume，HR，myocardial contractility • SVR：阻力小动脉结构改变 血管壁顺应性降低 血管的舒缩状态改变
Clinical Manifestation Early: asymptom, great BP variation headache, dizziness, palpitation, fatigue A2↑s4, aortic area sM Late: manifestation of complications brain, heart, eye, kidney, vessel damage
Clinical Manifestation • Early: asymptom， great BP variation headache，dizziness，palpitation，fatigue A2 S4，aortic area SM • Late: manifestation of complications brain, heart，eye, kidney, vessel damage
Clinical Manifestation Target organ related to accelerated As related to BP level heart angina、MI,SD heart failure Brain IA, brain thrombosis cerebral hemorrhage encephalopath Kidney renal angiopathy renal arteriolosclerosis renal failure Artery blocking lesion aortic dissection
Clinical Manifestation Target organ related to accelerated AS related to BP level heart angina、MI，SD heart failure Brain TIA， brain thrombosis cerebral hemorrhage encephalopathy Kidney renal angiopathy renal arteriolosclerosis renal failure Artery blocking lesion aortic dissection
Clinical Manifestation Most common complications are from brain, 4-6 times faMI。 Include: TIA, brain thrombosis, brain infarction(包括腔隙 性脑梗塞), encephalopathy, cerebral hemorrhage
Clinical Manifestation Most common complications are from brain， 4-6 times of AMI 。 Include: TIA， brain thrombosis，brain infarction（包括腔隙 性脑梗塞）, encephalopathy ， cerebral hemorrhage
Hypertension and Stroke A. Both SBP DBP positively related to stroke risk .l DBP< 5mmHg, stroke risk decrease 35-40% 不存在这样一个DBP的低限水平,低于这一水平时 stroke risk不再继续下降。 Following the aging, stroke incidence increase rapidly 血压水平与脑出血和脑梗塞都有相关关系,但似乎与脑出 血的关系更陡直一些
Hypertension and Stroke • Both SBP & DBP positively related to stroke risk • DBP< 5mmHg, stroke risk decrease 35 - 40%。 • 不存在这样一个DBP的低限水平，低于这一水平时， stroke risk不再继续下降。 • Following the aging， stroke incidence increase rapidly。 • 血压水平与脑出血和脑梗塞都有相关关系，但似乎与脑出 血的关系更陡直一些