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Portal hypertension is defined as increased portal venous pressure, with a hepatic venous pressure gradient greater than 5 mmHg. [3] [4] Normal portal pressure is 1–4 mmHg; clinically insignificant portal hypertension is present at portal pressures 5–9 mmHg; clinically significant portal hypertension is present at portal pressures greater than 10 mmHg. [5]
Guidelines for treating resistant hypertension have been published in the UK [45] and US. [46] It has been proposed that a proportion of resistant hypertension may be the result of chronic high activity of the autonomic nervous system, known as "neurogenic hypertension". [47] Low adherence to treatment is an important cause of resistant ...
The first line of treatment for hypertension is lifestyle changes, including dietary changes, physical exercise, and weight loss. Although these have all been recommended in scientific advisories, [7] a Cochrane systematic review of available relevant studies found that although weigh-loss diets did reduce body weight and blood pressure, beneficial effects of those changes could not be ...
By creating a shunt from the portal vein to the hepatic vein, this intervention allows portal blood an alternative avenue for draining into systemic circulation. In bypassing the flow-resistant liver, the net result is a reduced pressure drop across the liver and a decreased portal venous pressure. Decreased portal venous pressure in turn ...
An HVPG of ≥5 mmHg defines portal hypertension, and if the measurement exceeds 10 mmHg it is called clinically significant portal hypertension. Above 12 mm Hg, variceal haemorrhage may occur. [5] While not widely performed, its assessment in people with chronic liver disease is recommended to monitor response to treatment. [6]
In a hypertensive emergency, treatment should first be to stabilize the patient's airway, breathing, and circulation per ACLS guidelines. Patients should have their blood pressure slowly lowered over a period of minutes to hours with an antihypertensive agent.
Chronic care management encompasses the oversight and education activities conducted by health care provider to help patients with long term illness and health conditions such as diabetes, hypertension, lupus, multiple sclerosis, and stopping of breathing during asleep learn to understand their condition and live successfully with it.
Portopulmonary hypertension (PPH) [1] is defined by the coexistence of portal and pulmonary hypertension. PPH is a serious complication of liver disease, present in 0.25 to 4% of all patients with cirrhosis .