Khởi trị tăng huyết áp tại tuyến cơ sở

KH&I TRI MUV~T TAI TUY~N TING AP ~ CO SO TS BS TH S (VIN TIM MCH PHM I N VIT NAM) (i ~ ~ H(,ITIM ~CHHQ( QUOC GIAVI~ HQI NGHI TIM M~CH KHM THA ln (hi tin s, o HA & khỏm thc th THA CP CU HA 180/120 mmHg HA 140/90 mmHg KHM THA ln HA 140/90 Cể mmHg, cú tn thng c KHễNG quan ớch, hoc T T o HA ti nh HA KHM THA ln Holter HA 24h hoc CKD trung bỡnh ngy HA HA ban HATT 135 mmHg Hoc 140/90 ngy HATTr 85 mmHg HATT 135 mmHg mmHg CHN Ho ON TNG HUYT P MC TIấU IU TR THA NGI LN >18 TUI THA >18 tui Mc h HA chung: 3.0 mmol/L (115 mg/dL), va/hoc -HDL-C < 1.0 mmol/L (40 mg/dL) nam , < 1.2 mmol/L ( 46 mg/dL) n, va/hoc -TG > 1.7 mmol/L ( 150 mg/dL) ng mỏu oi bt thng Beo phi a thabu o n Beoi phi g ng Tin ng 7.0 mmmol/L ( 126 mg/dl) s mỏu gia ikhi nh o coi ngi b bnh tim mch sm ( < 55 hai tui vi nam va < 65 vi n ) lõn o liờn tip va /hoc HbA1c > % ( 53 mmol/mol) va /hoc ng mỏu sau n > 11.0 mmol/L ( 200 mg/dl) in tim day tht trỏi ( SL > 3.5 mV; RaVL > 1.1 mV; chi s Cornel > 244 mmV*ms) hoc Day M cnh (IMT > 0.9 mmm) hoc co mng va Vn tc song mch ui-M cnh > 10 m/s Chi s c chõn- cng tay < 0.9 Bnh thn giai on mn giai on ( eGFR: 30-60 ml/phut/1.73 m2) Albumine niu vi th ( 30-300 mg/24 gi) hoc ti alb /creatinine (30-300 mg/g hoc 3.4-34 mg/ mmol) ó cú bnh tim mch hoc bnh thõn Bnh mch nao: nhi mỏu nóo, xut huyt nao, TBMN thoỏng qua Bnh mch vanh: au tht ngc, NMCT; tỏi ti mỏu bng nong vanh hoc cõu ni Suy tim, bao gụm suy tim chc nng bo tụn Bnh M chi di co triu chng Bnh thn mn giai on (eGFR < 30 ml/ph/1.73 m2) gai th niu > 300 mg/24 gi Protein The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC) - J Hypertension 2013;31:1281-1357 Bnh vong mc tin trin: xut huyt hoc xut tit, phu Powered by PHN TNG NGUY C TIM MACH & THA Nhng yu t nguy c, tn thng c quan v bnh cnh lõm sng Bỡnh thng cao HATT :130-139 hoc HATTr: 8589 mmHg Khụng cú yu t nguy c THA HATT: 140-159 hoc HATTr: 9099 mmHg THA HATT: 160-179 hoc HATTr :100-109 mmHg THA HA 180 Nguy c thp Nguy c trung bỡnh Nguy c cao /110 mmHg Cú 1-2 yu t nguy c Nguy c thp Nguy c trung bỡnh Nguy c trung bỡnh n cao Nguy c cao Cú yu t nguy c, Nguy c thp n trung binh Nguy c trung binh n cao Nguy c cao Nguy c cao Tn thng c quan ớch, Bnh thõn mn g hoc thỏo ng Nguy c trung binh n cao Nguy c cao Nguy c cao Nguy c cao n rt cao Bnh Tim Mch cú triu chng, Bnh Thõn Mn g i kốm hoc T co TTCQ ớch/ nhiờu YTNC Nguy c rt cao Nguy c rt cao Nguy c rt cao HUI NGHI TIM MACH TOAN Nguy c rt cao X TR THA THEO PHN TNG NGUY C TIM MCH V PHN THA Nhng yu t nguy c, tn thng c quan v bnh cnh lõm sng Khụng cú yu t nguy c Cú 1-2 yu t nguy c Bỡnh thng cao HATT : 130-139 hoc HATTr : 85-89 mmHg THA HATT: 140-159 hoc HATTr : 9099 mmHg Khụng iờu tr TLS vi thỏng ri cho thuc t mc tiờu 110 mmHg thuc t mc 109mmHg tiờu