10/21 Flashcards
HTN
persistently elevated arterial BP
one of the most important preventable contributors to disease and death
pulmonary HTN
abnormal elevation or artery pressure
may be the result of left heart failure, pulmonary parenchymal or vascular disease, thromboembolism or a combination of these factors
essential (primary) HTN:
90% HN patients
unknown etiology, genetics may play a role
secondary HTN
one or more factors contributing to the development of HTN
epidemiology
1/3 american adults (~78 million) adults have HTN
race: AA
Age: common in the elderly
risk factors: old age, male, AA, obesity, high Na intake, low K intake, excess alcohol intake, FH
normal BP
> 120/>80
preHTN
120-139/80-89
stage 1 HTN
140-159/90-99
stage 2 HTN
> 160/>100
CVD risk
the BP relationship to risk of CVD is continuous, consistent and independent of other risk factors
every increment of ___ mmHg doubles risk of CVD starting at ___ mmHg
20/10
115/75
-preHTN signals the need for increased education to reduce BP and prevent HTN
pathophys of primary HTN
abnormalities with: humoral (RAAS, natiuretic hormone, insulin resistance, hyperinsulinemia) vascular endothelial mechanisms neuronal mechanisms peripheral autoregulation defects electrolyte disturbances
likely multiple mechanisms contribute
causes of secondary HTN
sleep apnea, drug/food induced (NSAIDs, CS, estrogen, OC, sympathomimetic amines, erythropoetin, ketoconazole), CKD, primary aldosteronsim, renovascular disease, steroids (cushing’s), thyroid disease
primary aldosteronism
prevalance: 0.5-2%
adrenal adenoma
clinical: asymptomatic, HA, muscle cramps, retinopathy, hypokalemia, metabolic acidosis, norm-high Na
test individuals w treatment-resistant HTN (>140/90 w 3 meds), mod/severe HTN, adrenal tumor, FH
tx: surgically remove
mean arterial pressure (MAP)
=1/3 (SBP) + 2/3 (DBP)
represents average pressure exerted on arterial walls during 1 cardiac cycle
normal: 70-11
