• Have your blood pressure HYPERTENSION (HIGH BLOOD HYPERTENSION (HIGH BLOOD PRESSURE: PRESSURE) checked three to four times a Current guidelines state that year; it should be less than normal blood pressure is less than World Wide estimates of individuals 130/80mm Hg. with hypertension are 1 billion Pre-hypertension is systolic blood people currently. (Source: Joint National Committee pressure of 120-139mm Hg or diastolic On Prevention, Detection, Evaluation blood pressure of 80-89mm Hg. In 2000, 972 million adults were Stage 1 hypertension is systolic estimated to have hypertension (high And Treatment Of High Blood blood pressure of 140-159 mm Hg or blood pressure) worldwide. By 2025, Pressure. diastolic blood pressure of 90-99 mm that number is estimated to rise to Http://Www.Nhlbi.Nih.Gov/Guidelines 1.56 billion. (The Lancet; 365: 9455 /Hypertension/Jnc7full.Pdf) Stage 2 hypertension is systolic January 15, 2005:217-223) blood pressure of 160mm Hg or greater or diastolic blood pressure of 100mm 73 million individuals in the United My blood pressure is _________. Hg or greater. States had hypertension in 2005. Regular screening for (www.americanheart.org/statistics)
• See if your doctor can prescribe hypertension should be done at least every 2 years and more frequently in The risk of cardiovascular disease, an ARB Therapy (Angiotensin minority population and the elderly. beginning at 115/75 mm Hg doubles Receptor Blocker) (Example: with each increment of 20/10 mm Hg. Valsartan, Irbesartan, Losartan), (Source: Joint National Committee On or ACE Inhibitor Therapy Prevention, Detection, Evaluation And (Source: Joint National Committee Treatment Of High Blood Pressure. On Prevention, Detection, Evaluation (Angiotensin Converting Enzyme http://www.nhlbi.nih.gov/guidelines/hyp And Treatment Of High Blood Inhibitor) (Example: Ramipril, ertension/jnc7full.pdf) Pressure. Lisinopril, Enalapril) for blood http://www.nhlbi.nih.gov/guidelines/h pressure control and for The JNC VII/American Diabetes ypertension/jnc7full.htm) Association/American Heart protective effect for your kidneys, Association/recommendation is Every 10mm lower usual systolic heart, and brain. maintaining blood pressure of less blood pressure or a 5mm lower usual than 130/80 mm Hg. diastolic blood pressure would
• Combination therapy using ARB (www.guidelines.gov) predict a 50-60% lower risk of stroke death and approximately 40-50% Therapy (Example: Valsartan, lower risk of death due to coronary Irbesartan, Losartan) or ACE artery disease or other vascular Inhibitor Therapy (Example: Ramipril, Lisinopril, Vasotec) With (AHA Scientific Statement Circulation, 2007; 115:2761-2788 a Calcium Channel Blocker Clive Rosendorff M.D. et.al. (Amlodipine) may provide faster http://circ.ahajournals.org/cgi/conten achievement of blood pressure t/full/115/21/2761) goal and better protective effect for your heart and brain. Controlling blood pressure leads to 16-25% risk reduction for MI, stroke, and cardiovascular You may need additional therapy mortality (ASCOT, LIFE, with beta blockers, calcium channel MICROHOPE)
blockers, and direct renin inhibitor to Controlling blood pressure achieve blood pressure goal. reduces stroke risk by 22-50% (UKPDS, LIFE, MICROHOPE) My blood pressure medications are ________________________________ Controlling blood pressure with ________________________________ Valsartan in the VALUE Trial, led ________________________________ to 19% fewer hospitalizations for _________ heart failure, compared to the Amlodipine group.
However failure to control blood pressure with Valsartan to the same level as Amlodipine in the first 6 months, led to increased risk of stroke, myocardial infarction, and death. Therefore it is important to achieve blood pressure goal sooner than later. (Stevo Julius et al. The Lancet; 19. June, 2004;363;9426;2022-2031 http://www.lancet.com/journals/lance t/article/PIIS0140-6736(04)16451- 9/fulltext) Controlling blood pressure with a combination of calcium channel blocker (Amlodipine) and ACE inhibitor (Perindopril) showed a 14- 26% risk reduction for myocardial infarction, angina, heart failure, stroke, peripheral arterial disease, new onset of renal insufficiency, and cardiovascular events and mortality compared to the regimen using beta- blocker (Atenolol) and thiazide diuretic. (ASCOT-BPLA Study: Björn Dahlöf et al. The Lancet; 366;9489;895-906 http://www.thelancet.com/journals/la ncet/article/PIIS0140-6736(05)67185- 1/fulltext)
http://www.chicagobusiness.com/cgi-bin/article.pl?article_id=28921&seenIt=1Exelon Corp. is close to a deal to turn over its mothballed Zion nuclear power plant to an outside contractor that promises to clean up the North Shore site in 10 years — four decades faster than the current plan. Exelon says it now favors a fast-track cleanup over another option that's been on the table: ref
Associação Portuguesa de Projectistas e Consultores TOMADAS DE POSIÇÃO LEGISLAÇÃO E QUALIDADE DOS ACTOS A APPC entende que o Estado, na qualidade de produtor de Legislação, deve reduzir a sua intervenção. É desejável que exista menos legislação e mais fácil de compreender e usar e que sobretudo seja bem aplicada e adequada à realidade nacional. A APPC deseja que o Es