hta diabetes tbc peru 2016
TRANSCRIPT
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HTA
JORGE A. REBAZA NEIRAMÉDICO CIRUJANO-CMP 48044
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DEFINICIÓN
• Enfermedad vascular, arterial, sistémica, inflamatoria-crónica,
• Sin etiología definida• Elevación anormal y persistente
de la presión arterial sistólica o diastólica.
• En mayores de 18 años• Presión arterial sistólica ≥ 140• Presión arterial diastólica ≥ 90
MINSA GPC, 2014
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ETIOLOGIAHIPERTENSION PRIMARIA(ESENCIAL O IDIOPATICA)
HIPERTENSION SECUNDARIA
• Sin causa identificable • Existen múltiples
factores relacionados pero no con categoría de causa y efecto
• Más del 95% de casos
• Con causa identificable • Menos del 5% de los
casos- Enf. renal- Enf. endocrinas- Tumores, coartación
de aorta, Enf. Paget.- Medicamentos
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FISIOPATOLOGIA
La presión arterial es una enfermedad vascular:-Regulada por numerosos factores neuro-hormonales -Acción sistémica y local-Funcionan en circuitos de autorregulación
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ENDES 2013
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Fuente: Resultados de la Encuesta Demográfica y de Salud Familiar 2013
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Personas de 15 y más años de edad que consumen al menos cinco porciones de fruta y/o ensalada de verduras al día, según característica seleccionada.
Prevalencia en > 15 años = 10.8• Varones 9.7%• Mujeres 11.8%• Área urbana 12.9%• Área rural 4.5%• Costa 14.0%• Sierra 5.3%• Selva 9.8%
Personas de 15 y más años de edad que consumen al menos cinco porciones de fruta y/o ensalada de
verduras al día según niveles de instrucción. Perú 2014
Fuente: ENDES 2014. Instituto Nacional de Estadística e Informática. Elaboración ESNPCDNT- MINSA.
Hasta primaria Secundaria Superior0.02.04.06.08.0
10.012.014.016.018.0
5.4
10.9
16.4
Quintil infer
ior
Segundo quintil
Quintil inter
medio
Cuarto quintil
Quintil superi
or0.0
5.0
10.0
15.0
20.0
25.0
3.66.8
10.312.8
19.5
Personas de 15 y más años de edad que consumen al menos cinco porciones de fruta y/o ensalada de
verduras al día según quintiles de bienestar. Perú 2014
Fuente: ENDES 2014. Instituto Nacional de Estadística e Informática. Elaboración ESNPCDNT- MINSA.
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OMS 2013
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FACTORES DE RIESGO ASOCIADOS
MEDIO AMBIENTE
ESTILO DE VIDA
RIESGO CARDIOVASCULAR
FACTORES HEREDITARIOS
NIVEL PA
FACTORES DE RIESGO
DAÑO ASINTOMATICO A ORGANO BLANCO
EVENTO VASCULAR
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MEDIO AMBIENTE
• La contaminación del aire tiene una estrecha relación con hospitalización y mortalidad por insuficiencia.
• Monoxido de carbono, dioxido de sulfuro, ozono, PM 2.5, PM 10.
SHAH AS, 2013
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ESTILOS DE VIDA
• Tabaquismo• Sedentarismo • Café• Alcohol• Dieta malsana
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NIVEL DE PRESIÓN ARTERIALCategorías Sistólica (mmHG) Diastólica (mmHg)
Normal <120 <80
Pre-hipertensión 120-139 80-89
Hipertensión ≥140 ≥90
Estadio 1 140-159 90-99
Estadio 2 ≥160 ≥100
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1. Enfermedad cerebrovascular: ictus isquémico, hemorragia cerebral, accidente isquémico transitorio.
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Enfermedad coronaria: infarto de miocardio, angina, revascularización coronaria con intervención coronaria percutánea o cirugía de revascularización coronaria.
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Insuficiencia cardiaca con o sin función sistólica preservada
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Enfermedad arterial periférica sintomática en extremidades inferiores
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1. Enfermedad renal crónica con TFGe<30 ml/min/1.73 m2, proteinuria (>300mg/24h)
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Retinopatía avanzada: hemorragia o exudado, papiledema
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Medidas generales y preventivasREDUCCIÓN DE PESO
IMC 18.5 – 24.9 Kg/m2Perímetro abdominal: < 102cm varones y < 88cm en mujeresDIETA:Consumo de frutas, vegetales frescos y alimentos bajos en grasas totales y saturadasREDUCIR EL CONSUMO DE SAL: Menos de 5g/ díaACTIVIDAD FÍSICAEjercicio físico aeróbico de moderada intensidadAl menos 30 min al día o 150 semanales
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Medidas generales y preventivasEVITAR CONSUMO DE ALCOHOL
Evitar el consumo de alcoholNo exceder de 20 – 30 g/día de etanol en varonesNo exceder de 10 – 20 g/día de etanol en mujeres
oConsumo semanal menor de 140 g en varones Consumo semanal menor de 80 g en mujeres
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Medidas generales y preventivas
NO AL TABACO
Abandono total del habito de fumarNo exposición al humo del tabaco
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Inicio de terapia farmacológica
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Intervenciones según riesgo cardiovascular
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Intervenciones según riesgo cardiovascular
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Intervenciones según riesgo cardiovascular
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Intervenciones según riesgo cardiovascular
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DIABETES MELLITUS
JORGE A. REBAZA NEIRAMÉDICO CIRUJANO-CMP 48044
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TBC
JORGE A. REBAZA NEIRAMÉDICO CIRUJANO-CMP 48044
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TBC
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GRACIAS