9571 - H yper tension update Which guideline to follow? Dr...

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Unformatted text preview: H yper tension update Which guideline to follow? Dr Sunita Dodani Department of Family Medicine Aga Khan University Karachi, Pakistan February 23,2003 Pr esentation outline World Wide Epidemic: Some Figures Epidemiological Transition & Hypertension Data From Developing Countries EMRO Work Statistics From Pakistan: NHSP Hypertension Guidelines Currently available guidelines Similarities in guidelines Differences in guidelines Pr esentation outline Hypertension Guidelines (Cont’d) Still Unanswered Questions What is needed in Pakistan Epidemiologic research Which guideline to follow? JNC VI guideline (1994) Risk stratification Wor ldwide Epidemic: Some Figur es affect all ages, but primarily occurs in adults. 20% prevalence,approximately 690m people have hypertension world wide major risk factor for stroke, coronary heart disease and kidney failure 30% of deaths worldwide (15 million) are due to cardiovascular diseases 5 million deaths / year worldwide due to strokes alone, with another 30 million suffering from its disabling effects. ( Geneva, Switzerland November 15-16, 1999) Epidemiological Tr ansition & H yper tension Developing countries experiencing rapid health transition, escalating relative and absolute burdens of CVD Determinants of transition a) demographic (increased life expectancy) b) lifestyle changes c) urbanization, industrialization and globalization Epidemiological Tr ansition & H yper tension (Cont’d) In developing countries ,steady increase in hypertension prevalence over the last 50 years, more in urban than in rural areas (WHO report 2002) W H O Regions World regions according to WHO • Easter n Mediter r anean r egion (EMR) (Jordan, Iran, Srilanka, Pakistan, Egypt Oman, Saudi Arabia , Bangladesh etc) Paucity of large, authentic, epidemiological studies Limited data available in the form of small studies Majority of studies done have shortcomings differing examination techniques differing diagnostic criteria screening blood pressure values used The studies are not representative of the total population Limited to single centers or single community EMR (cont'd…) M ajority of third world countries lack sufficient national estimates of the prevalence of hypertension In developing countries ,steady increase in hypertension prevalence over the last 50 EMR…. Some pr evalence figur es Saudi Arabia 10-15% (EMRO bulletin 2001)...
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This note was uploaded on 02/23/2012 for the course PHARM 290 taught by Professor Staff during the Fall '10 term at Rutgers.

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9571 - H yper tension update Which guideline to follow? Dr...

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