10/14 Flashcards
HTN diagnosis
-Often asymptomatic (may observe dizziness or headache)
-Two or more measurements of blood pressure with
diastolic pressure > 90 mm Hg, Systolic pressure > 140 mm Hg
-Pulse Pressure (SBP-DBP) > 65 mm Hg VERY important
indicator
- >50 yo, SBP > 140 mm Hg very important cardiovascular
disease risk factor
pre HTN
120-139 / 80-89
stage 1 HTN
140-159 / 90-99
stage 2 HTN
> 160 / > 100
BP = __ x __
CO x PVR
chronic BP is controlled by
kidneys
angiotensin pathway
angiotensinogen -(renin)-> ang I -(ACE)-> ang II
normal BP
less than 120/80
essential or primary HTN
- 85- 90% of cases
- no identifiable cause
- increase peripheral vascular resistance (PVR); normal cardiac output (CO)
essential HTN risk factors
FH, sex, diet, smoking, DM, hyperlipidemia
other causes of HTN
- renal artery constriction
- coarctation of the aorta
- pheochromocytoma
- cushing’s
- primary aldosteronism
why treat HTN?
end organ damage: kidney, heart, brain
goal of HTN therapy
-reduce diastolic BP to reduce incidence of end organ damage
BP = CO x PVR
-reduce CO
-reduce PVR (vasodilation, decrease blood volume)
actions of ang II
- vasoconstrictor
- stimulates aldosterone release (aldosterone stimulates Na/water retention)
reserpine MOA
inhibits dopamine pump into vesicles, dopamine cant be converted to NE, NE cant be released into the synapse; depletes vascular pool of NE; slow onset of action, sustained effect
