1. HYPERTENSION SUMMIT

2. Hypertension Epidemiology Prevalence of Hypertension worldwide: – 1 Billion Deaths worldwide: – 7 million per year In USA, 90% lifetime risk of Hypertension is normal at age 55. Suboptimal blood pressure is the number one attributable cause of death in the world. Hypertension is the most common cause of preventable death in developed countries. Hypertension is the number one cause of congestive heart failure and stroke, plus the second leading cause of renal failure.

3. HYPERTENSION - Classification ClassificationSystolic ReadingDiastolic Reading Normal120 mmHg80 mmHg Pre-Hypertension121 – 139 mmHg81 – 89 mmHg Stage I140 – 159 mmHg90 – 99 mmHg Stage II160 mmHg100 mmHg New JNC February 5, 2014 < 60 Years of age < 140 / 90 >60 Years of age < 150 / 90 Chronic kidney disease and Diabetes < 140 / 90

4. RAAS (Renin-Angiotensis System) Angotensinogen (Liver) (Kidney) Renin Beta Blockers Angiotensin I (Inactive) (Lung) Angiotensin Converting Enzyme ACE Inhibitors Angiotensin II (Active) VasoconstrictionAdrenal Angiotensin II Receptor Blocker Aldosterone Eplerenone Aldosterone Receptor Blocker (Spironolactone) (Kidney) Sodium Retention

5. RAAS (Renin-Angiotensis System) RENIN – Formed and stored in granules in the juxtaglomerular cells. – Renin release is stimulated by low plasma sodium, reduced chloride into tubular fluid at macula densa, reduced stretch of the juxtaglomerular cells, with reduced blood pressure, and activation of β-receptors on the juxtaglomerular cells. ANGIOTENSINGOGEN – Produced in the liver, and converted to angiotensin I by renin. ANGIOTENSIN I – Converted to angiotensin II by converting enzyme from lungs (angiotensin converting enzymes) ANGIOTENSIN II – Form angiotensin I by angiotensin converting enzymes and is an extremely potent vasoconstrictor and bind to zona glomerulosa (adrenal) to release aldosterone. ALDOSTERONE – Product of zona glomerulosa to sustain extracellular fluid volume by conserving body sodium.

6. Thank You Dr. James Lock – Internal Medicine – Hypertension Specialist East Central Mississippi Health Care Inc Walnut Grove Medical Clinic 199 Rimmer Street Walnut Grove, MS 39189 601-253-2733