Seminario Taller Hipertensión Arterial Guía de Manejo JNC8

Slides:



Advertisements
Presentaciones similares
En México en el año 2000 prevalencia 30.05% (20 y 69 años) 15,000 Mexicanos 43.2% HAS (Salud Publica de México 2010) EUA % >18 años
Advertisements

Fanny B. Cegla Enero – 2014 C.S. Buenos Aires
Control en cascada.
TRATAMIENTO DE LA HTA Y NEFROPROTECCIÓN
7mo Simposio internacional de hipertensión arterial y V taller de riesgo Vascular 26 ar 30 de mayo/2014 Santa Clara Dr.C Jorge P. Alfonzo Guerra Instituto.
GERARDO YALENKO OLIVERA ARMAS MEDICINA INTERNA
Preguntas Esenciales 1.What are essential questions? What are their purpose in learning? 2.Look over the essential questions and think about how they might.
Saber and Conocer Both verbs mean “to know” Both are regular verbs, except in the “yo” form –Saber: Yo sé, tú sabes, él sabe, nosotros sabemos, ellos.
Dra. Mª Lledó Tàrrega Porcar R3MFYC Tutor: Dr. Manuel Batalla Sales.
Valencia(Spain) Regional strategies and best practices.
HIPERTENSION ARTERIAL
Notes #18 Numbers 31 and higher Standard 1.2
BENEFICIOS DEL TRATAMIENTO DE LA HIPERTENSIÓN ARTERIAL PROF. DR. JORGE RESK HOSPITAL NACIONAL DE CLINICAS UNIVERSIDAD NACIONAL DE CORDOBA PROF. DR. JORGE.
Calentamiento Write the answers to each question.
Definite & indefinite articles
Digital Photography: Selfie Slides Liliana Martinez 10/27/14 4b.
Digital Photography: Selfie Slides Your Name Date Class Period.
Nina Jackson, Presenter.  IMSCI is research based writing instruction.  IMSCI uses the gradual release of responsibility model to teach writing.  Scaffolds.
Digital Photography: Selfie Slides By: Essence L. Thomas.
MÉDICINA INTERNA-HRDT
TOPICS: SABER/CONOCER AND YO-GO VERBS Essential questions: How do I say whom and what I know? How do I use some other irregular verbs?
Essential ?: How do I conjugate this irregular verb and how is it used?
Las clases de Sra. Schwarz Realidades 1 The “To Be” Verbs Ser and Estar.
Un juego de adivinanzas: ¿Dónde está el tesoro? A1B1C1D1E1F1 A4B4C4D4E4F4 A2B2C2D2E2F2 A5B5C5D5E5F5 A3B3C3D3E3F3 A6B6C6D6E6F6 Inténtalo de nuevo Inténtalo.
Essential question: How do I conjugate these new verbs and use them?
PRESENTACIÓN DE POSTER María Carolina Valverde Vasile SCEMT – Año 2016.
Hypothyroidism Alma Cruz Simancas UNIVERSIDAD AUTÓNOMA BENITO JUÁREZ DE OAXACA FACULTAD DE MEDICINA Y CIRUGÍAFACULTAD DE MEDICINA Y CIRUGÍA «INGLES MÉDICO»«INGLES.
President Argentina Federation of Cardiology
Dra. Mª Lledó Tàrrega Porcar R3MFYC Tutor: Dr. Manuel Batalla Sales
To be, or not to be? Let’s start out with one of the most important verbs in Spanish: ser, which means “to be.”
THIS WILL BE COLLECTED AT THE END OF THE PERIOD.
EPIDEMIOLOGY. The study of the spread and control of diseases in the community requires analysis of frequency The number of times something occurs in.
Algoritmo para el tratamiento de la obesidad
Task Based Approach Activity by Micaela Moreyra
Comparatives & Superlatives
El 28 de Agosto Objetivos:
First Grade Dual High Frequency Words
New Data and How They Change What We Know About Heart Failure.
*YOU HAVE 5 MINUTES* Objective: Vocab/Ideas: Vámonos:
More sentences that contain if…
Farmacoterapia de la Hipertensión Arterial
Youden Analysis. Introduction to W. J. Youden Components of the Youden Graph Calculations Getting the “Circle” What to do with the results.
Facultad de Ciencias Pecuarias INGENIERÍA EN ALIMENTOS THEME: Does safety information influence consumers’ preferences for controversial food products?
PROFESSIONALPOWERPOINT.COM FREE PPT TEMPLATES DOWNLOAD MORE POWERPOINT TEMPLATES FROM PROFESSIONALPOWERPOINT.COM.
ACTUALIZACIÓN DE HIPERTENSIÓN ARTERIAL
Genentech A Discussion Winter 2018Joseph Milner, RSM54011.
SISTEMAS METEOROLOGICOS MARIA JORDAN FISICA. Parents have the right to know that their child will be safe at school, both physically and emotionally.
You will now learn the imperfect, which describes past activities in a different way. Copyright © 2008 Vista Higher Learning. All rights reserved.
Comparativos.
Introducción a las finanzas de los sistemas de agua potables
Dr. Jorge Estigarribia Tutor: Dr. Rafael Gonzalez EMERGETOLOGIA-IPS
Enfermedad Renal crónica
Comparatives.
Quasimodo: Tienes que hacer parte D de la tarea..
You’ve already learned how to use interrogative words and phrases
Demonstrative Adjectives Adverbs of place
Miranda Rights El Aviso Miranda
You’ve already learned how to use interrogative words and phrases
NOMBRE: FRANSHESCA URREGO FERNANDEZ GRADO:8ª PROFESORA: LIDA ROMERO INSTITUCION EDUCATIVA JOSE EUSTACIO RIVERA.
Romaine Outbreak Summary
Los adjetivos demostrativos Notes #16 What is a demonstrative adjective in English? Demonstrative adjectives in English are simply the words: THISTHESE.
Gustar, Interesar, Aburrir
Development of the concert programme
You’ve already learned how to use interrogative words and phrases
Comparatives.
Setting SMART Goals If goals aren’t reachable, they aren’t worth making. All you have to do to set realistic goals is follow the SMART goals guidelines.
How to write my report. Checklist – what I need to include Cover page Contents page – with sections Introduction - aims of project - background information.
Enfermedad caracterizada aumento de presión arterial persistente en arterias sistémicas. Guias Clinicas (ESC 2013/JNC 7):
Las Preguntas (the questions) Tengo una pregunta… Sí, Juan habla mucho con el profesor en clase. No, Juan no habla mucho en clase. s vo s vo Forming.
Transcripción de la presentación:

Seminario Taller Hipertensión Arterial Guía de Manejo JNC8 Salud Publica II Taller Manejo de la Hipertensión Arterial 16/11/2018

2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults Report From the Panel Members Appointed to the Eighth Joint National Committee (JNC 8) JAMA. Published online December 18,2013.doi:10.1001/jama.2013.284427 Taller Manejo de la Hipertensión Arterial 16/11/2018

Taller Manejo de la Hipertensión Arterial 16/11/2018

Editorial Assessing the Trustworthiness of the Guideline for Management of High Blood Pressure in Adults JAMA. 2013;():. doi:10.1001/jama.2013.284429. Editorial Recommendations for Treating Hypertension:What Are the Right Goals and Purposes? Editorial Updated Guidelines for Management of High Blood Pressure:Recommendations, Review, and Responsibility Taller Manejo de la Hipertensión Arterial 16/11/2018

Guías Clínicas de Hipertension arterial ABSTRACT Notas al pie Resumen JNC 8 Guías Clínicas de Hipertension arterial ABSTRACT  Hypertension is the most common condition seen in primary care and leads to myocardial infarction, stroke, renal failure, and death if not detected early and treated appropriately. Patients want to be assured that blood pressure (BP) treatment will reduce their disease burden, while clinicians want guidance on hypertension management using the best scientific evidence. This report takes a rigorous, evidence-based approach to recommend treatment thresholds, goals, and medications in the management of hypertension in adults. Evidence was drawn from randomized controlled trials, which represent the gold standard for determining efficacy and effectiveness. Evidence quality and recommendations were graded based on their effect on important outcomes. There is strong evidence to support treating hypertensive persons aged 60 years or older to a BP goal of less than 150/90 mm Hg and hypertensive persons 30 through 59 years of age to a diastolic goal of less than 90 mm Hg; however, there is insufficient evidence in hypertensive persons younger than 60 years for a systolic goal, or in those younger than 30 years for a diastolic goal, so the panel recommends a BP of less than 140/90 mm Hg for those groups based on expert opinion. The same thresholds and goals are recommended for hypertensive adults with diabetes or nondiabetic chronic kidney disease (CKD) as for the general hypertensive population younger than 60 years. There is moderate evidence to support initiating drug treatment with an angiotensin-converting enzyme inhibitor, angiotensin receptor blocker, calcium channel blocker, or thiazide-type diuretic in the nonblack hypertensive population, including those with diabetes. In the black hypertensive population, including those with diabetes, a calcium channel blocker or thiazide-type diuretic is recommended as initial therapy. There is moderate evidence to support initial or add-on antihypertensive therapy with an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker in persons with CKD to improve kidney outcomes. Although this guideline provides evidence-based recommendations for the management of high BP and should meet the clinical needs of most patients, these recommendations are not a substitute for clinical judgment, and decisions about care must carefully consider and incorporate the clinical characteristics and circumstances of each individual patient. Hypertension remains one of the most important preventable contributors to disease and death. Abundant evidence from randomized controlled trials (RCTs) has shown benefit of antihypertensive drug treatment in reducing important health outcomes in persons with hypertension.1- 3 Clinical guidelines are at the intersection between research evidence and clinical actions that can improve patient outcomes. The Institute of Medicine Report Clinical Practice Guidelines We Can Trustoutlined a pathway to guideline development and is the approach that this panel aspired to in the creation of this report.4 The panel members appointed to the Eighth Joint National Committee (JNC 8) used rigorous evidence-based methods, developing Evidence Statements and recommendations for blood pressure (BP) treatment based on a systematic review of the literature to meet user needs, especially the needs of the primary care clinician. This report is an executive summary of the evidence and is designed to provide clear recommendations for all clinicians. Major differences from the previous JNC report are summarized in Table 1. The complete evidence summary and detailed description of the evidence review and methods are provided online (see Supplement). Taller Manejo de la Hipertensión Arterial 16/11/2018

Resumen This report takes a rigorous, evidence-based approach to recommend treatment thresholds, goals, and medications in the management of hypertension in adults.  Umbrales para iniciartratamiento,objetivos y manejo con medicamentos, para la hipertension de la población adulta. Taller Manejo de la Hipertensión Arterial 16/11/2018

Evidencia. There is strong evidence to support treating hypertensive persons aged 60 years or older to a BP goal of less than 150/90 mm Hg and hypertensive persons 30 through 59 years of age to a diastolic goal of less than 90 mm Hg; Tenemos fuerte evidencia para recomendar el tratamiento de pacientes hipertensión de 60 años o mayores, para lograr un control, cifra de 150/90 mmHg. Para hipertensos de 30 a 59 años de edad los valores de presion diastolica deben ser5 menores de 90mmHg. Taller Manejo de la Hipertensión Arterial 16/11/2018

Evidencia …however, there is insufficient evidence in hypertensive persons younger than 60 years for a systolic goal, or in those younger than 30 years for a diastolic goal, so the panel recommends a BP of less than 140/90 mm Hg for those groups based on expert opinion.  No hay suficiente evidencia para recomendar a pacientes hipertensos menores de 60 años , sus valores de presión sistólica, o en los más jóvenes , menores de 3o años sus valores de presión diastólica. El Panel de expertos recomienda : valores de PA menores de 140/90 para estos grupos. Taller Manejo de la Hipertensión Arterial 16/11/2018

Evidencia The same thresholds and goals are recommended for hypertensive adults with diabetes or nondiabetic chronic kidney disease (CKD) as for the general hypertensive population younger than 60 years.  Los mismos umbrales deben considerarse para hipertensos adultos con diabetes, o enfermedad renal no daibética, de manera análoga a la población hipertensa menor de 60 años. Taller Manejo de la Hipertensión Arterial 16/11/2018

Evidencia moderada existe para recomendar Iniciar con un inhibidor de la ECA, Un bloqueador de los receptores de la ECA, un bloqueador de los canales de calcio, o un diurético tipo tiazidico en la población hipertensa no afroamericana, incluyendo los diabéticos. En los afro americanos incluyendo los diabéticos , se recomienda usar un calcio antagonista o un diurético tiazidico como tratamiento inicial. En los pacientes con enfermedad renal crónica, se sugiere agregar un inhibidor de la ECA, o un bloqueador de los receptores de la ECA, para mejorar los resultados esperados en el órgano blanco ( riñón). There is moderate evidence to support initiating drug treatment with an angiotensin-converting enzyme inhibitor, angiotensin receptor blocker, calcium channel blocker, or thiazide-type diuretic in the nonblack hypertensive population, including those with diabetes. In the black hypertensive population, including those with diabetes, a calcium channel blocker or thiazide-type diuretic is recommended as initial therapy. There is moderate evidence to support initial or add-on antihypertensive therapy with an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker in persons with CKD to improve kidney outcomes. Taller Manejo de la Hipertensión Arterial 16/11/2018

Download Slide (.ppt) Taller Manejo de la Hipertensión Arterial 16/11/2018

QUESTIONS GUIDING THE EVIDENCE REVIEW ¿ Tres preguntas ? ¿ El hecho de iniciar la terapia farmacológica antihipertensiva en adultos, en un umbral determinado , tiene consecuencias ( mejoría ) en los resultados de salud ?. ¿ Perseguir un objetivo con la terapia antihipertensiva farmacológica tiene como consecuencias mejoría en el estado de salud. ¿ En pacientes hipertensos adultos , los diferentes tratamientos con medicamentos de una u otra clase difieren en los beneficios y efectos dañinos para la salud ? In adults with hypertension, does initiating antihypertensive pharmacologic therapy at specific BP thresholds improve health outcomes? In adults with hypertension, does treatment with antihypertensive pharmacologic therapy to a specified BP goal lead to improvements in health outcomes? In adults with hypertension, do various antihypertensive drugs or drug classes differ in comparative benefits and harms on specific health outcomes? Taller Manejo de la Hipertensión Arterial 16/11/2018

Download Slide (.ppt) Taller Manejo de la Hipertensión Arterial 16/11/2018

Download Slide (.ppt) Taller Manejo de la Hipertensión Arterial 16/11/2018

Taller Manejo de la Hipertensión Arterial 16/11/2018

RESULTADOS (RECOMENDACIONES) Taller Manejo de la Hipertensión Arterial 16/11/2018

RESULTADOS (RECOMENDACIONES) Taller Manejo de la Hipertensión Arterial 16/11/2018

RESULTADOS (RECOMENDACIONES) Taller Manejo de la Hipertensión Arterial 16/11/2018

Taller Manejo de la Hipertensión Arterial 16/11/2018

Taller Manejo de la Hipertensión Arterial 16/11/2018

Nicaragua, nuestra población de la Costa Atlántica Taller Manejo de la Hipertensión Arterial 16/11/2018

Algoritmo de tratamiento de la Presión Arterial Taller Manejo de la Hipertensión Arterial 16/11/2018

Algoritmo Manejo P.A. Taller Manejo de la Hipertensión Arterial 16/11/2018

Dosificación de los Medicamentos Antihipertensivos …Estrategia Taller Manejo de la Hipertensión Arterial 16/11/2018

Copyright © 2014 American Medical Association. All rights reserved. From: 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults:  Report From the Panel Members Appointed to the Eighth Joint National Committee (JNC 8) JAMA. 2013;():. doi:10.1001/jama.2013.284427 Figure Legend: Guideline Comparisons of Goal BP and Initial Drug Therapy for Adults With Hypertension Date of download: 1/17/2014 Copyright © 2014 American Medical Association. All rights reserved.