3 Hypertension Flashcards
What is the epidemiology of HTN?
- leading risk factor for CVD
- 50% of HTN patients are compliant with meds
- leading cause of mortality in US
What are the fast and slow regulation of BP mechanisms?
- Fast : Baroceptor (arch and carotid sinus)
- change sin pressure
- Slow: RAS (kidneys)
- Natriuetic peptites
- counter to RAAS
What regulates arterial blood flow?
- Sympathetic activity
- NorEph
Explain Hemodynamics with TPR
- Blood flow parallels CO
- Increase TPR = increase driving pressure to maintain BP at set rate
- Decrease TPR = decrease driving pressure
Explain the baroreflex? What happens during Chronic Hypertension?
- Mean Arterial pressure 85-100mmHg
- respond to stretching of arterial wall
- negaive feedback loop with vagus and glossopharyngeal
- Carotid sinus receptors range from 60-180mmHg
With Hypertension: Receptrs shift to the R (elevates)
What is the Renin-Angiostensin- Aldosterone System (RAAS)?
Detects low BF throough arteries of kindey
- SNS activity (Beta 1 receptors)
- Decreased BP in Renal ARtery
Increases vascular resistance and BP
- maintains pressure/prevent losing ability tp perfuse tissues
Renin + Angiotensin = Angiotensin I -> Ang II (constrictor/fluid retention)
What are the two types of Hypertension?
- Essential
- Secondary
What is Essential hypertension?
- cause unknown
- 95-99% of cases
- Interation between environmental factors and genetics
What is secondary Hypertension?
1-5% of cases
Results from biochemical/mechanical pathology
Potentially reversible
What are some hypertension contributors?
- Diet (salt sensitiveity)
- Obesity/Inactivity
- Abnormalities of the adrenal cortex
- sleep apnea
- SNS activity
- Kidney disease
- Congenital Vascular disroders
- recreational drugs and alc
What is normal BP values for adults?
100-120 / 60-80 mmHg
What is prehypertensive values for adults?
120-129/80-89
What are HBP values?
Stage 1: 140-159/90-99
Stage 2: 160+/90-99
Stage 3: 180+ / 110
What is a HTN Crises. Urgencies, and Emergencies?
- Urgencies BP> 180/110
- no signs of organ damage
- headache, nosebleed, faintness
- Emergencies BP > 180/120
- Signs/symptoms of organ damage
- Most Chest pain, dyspnea
What are common end organ damange HTN emergencies?
- Acute pulmonary edea
- Acute left Ventricular dysfunction
- Acute cornoary syndrome
- Cerebral infarction
- Hypertensive encephalopahy
Can cause acute injury to kidnesy
BP 300/150
kidney focal small hemorrhages