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BMS3052 > 42. Cardiovascular & Nutrition > Flashcards

42. Cardiovascular & Nutrition Flashcards

1
Q

Define

Systemic hypertension

A

high blood pressure in the systemic arteries - the vessels that carry blood from the heart to the body’s tissues (other than the lungs)

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2
Q

Define

Resistant hypertension

A

hypertension that is poorly responsive to treatment and requires the use of multiple medications to achieve acceptable blood pressure ranges

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3
Q

Define

Minoxidil

A

a peripheral vasodilator C9H15N5O used orally to treat hypertension and topically in a propylene glycol solution to promote hair regrowth in male-pattern baldness

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4
Q

Define

Renal denervation

A

a minimally invasive procedure to treat resistant hypertension. The procedure uses radiofrequency ablation to burn the nerves in the renal arteries. This process causes a reduction in the nerve activity, which decreases blood pressure

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5
Q

Definition

high blood pressure in the systemic arteries - the vessels that carry blood from the heart to the body’s tissues (other than the lungs)

A

Systemic hypertension

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6
Q

Definition

hypertension that is poorly responsive to treatment and requires the use of multiple medications to achieve acceptable blood pressure ranges

A

Resistant hypertension

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7
Q

Definition

a peripheral vasodilator C9H15N5O used orally to treat hypertension and topically in a propylene glycol solution to promote hair regrowth in male-pattern baldness

A

Minoxidil

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8
Q

Definition

a minimally invasive procedure to treat resistant hypertension. The procedure uses radiofrequency ablation to burn the nerves in the renal arteries. This process causes a reduction in the nerve activity, which decreases blood pressure

A

Renal denervation

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9
Q

Uncontrolled hypertension causes increased risk of what?

A

Stroke

Heart attack

Kidney failure

Blindness

Other complications

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10
Q

What are the risk factors of hypertension?

A

Genetics

Smoking

Stress

Environment

Diet

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11
Q

The cause of what percentage of primary hypertension is unknown?

A

90%

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12
Q

How does diet lead to cardiovascular disease?

A
  1. Dietary intake
  2. Altered gut bacteria
  3. Metabolism and immune system response
  4. Cardiovascular disease
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13
Q

What effects does a Western, Gluten-free and Mediterranean diet have on GIT integrity?

A

Both Western and Gluten free diets cause a decrease in good bacteria and an increase in bad

Mediterranean causes an increase in good bacteria

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14
Q

What have we found when administering AngII to both normal and germ free mice with regards to blood pressue? What can we conclude?

A

AngII causes a significant increase in BP in the normal mice

AngII has less of an effect on the BP of GF mice

Therefore, gut bacteria contribute to hypertension

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15
Q

Why is it important to understand how gut bacteria modulate metabolites?

A

Some metabolites, such as short chain fatty acids can reduce BP. Different metabolites are produced by difference bacteria and the composition of the gut microbiota is controlled by diet

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16
Q

How does eating more fibre lead to decrease BP?

A

Fibre leads to the production of more short-chain fatty acids by the bacteria in the gut which act to reduce blood pressure (and even neuroinflammation)

17
Q

Which short-chain fatty acids have been investigated for their effects on BP?

A

Acetate

Propionate

Butyrate

18
Q

Based on what we know about how diet effects BP, what are the potential treatmenst to prevent/reverse systemic hypertension?

A

Mediterranean/high fibre diet

Short chain fatty acids (SFCAs)

19
Q

What is the first line treatment for hypertension?

A

Control weight

Physical activity/exercise

Diet

Cease smoking

Decrease alcohol

20
Q

What are the pharmacological treatment options for hypertension?

A

Angiotensin converting enzyme inhibitors & angiotensin antagonists

Beta blockers

Calcium channel blockers (NOT for HF)

Diuretics (thiazides, loop, K+ sparing)

21
Q

What is resistant hypertension?

A

Blood pressure not under 140/90

3 BP lowering drugs used (1 is a diuretic)

At optimal dosage

22
Q

What risk factors are associated with resistant hypertension?

A

Obesity

Sleep apnea

Female

Diabetes

Black

Kidney disease

Age

Salt intake

Alcohol

23
Q

What are the patient related causes of resistant hypertension?

A

High Salt diet

Medications that raise BP

Life style choices

Not adhering BP medication plan

24
Q

What are the physician related causes of resistant hypertension?

A

Unsuspected secondary cause

Inadequate use of diuretics

Progressive renal insufficiency

25
Q

What needs to be considered when evaluating resistant hypertension?

A
  • Good Blood pressure recording technique – cuff size
  • Strict compliance with treatment recommendation
  • Evaluation of secondary causes of resistant hypertension
  • Ambulatory BP monitoring – exclude ”white coat” hypertension
  • History of drug intake that can cause resistant hypertension
  • Signs of sleep apnoea – snoring, daytime sleepiness
26
Q

What medications can interfere with BP control?

A
  • NSAIDS and aspirin
  • Sympathomimetic agents (decongestants)
  • Diet pills
  • Excessive alcohol
  • Licorice
  • Oral contraceptive pills
  • Erythropoietin
27
Q

What are the treatment options for resistant hypertension?

A
  • Optimise the current treatment plan
  • Treat identifiable cause if found
  • Mineralcorticoid receptor antagonists ie spironolactone
  • Effective diuresis ie furosemide
  • Minoxidil
28
Q

How can Minoxidil treat resistant hypertension?

A

Opening of KATP channels leads to vasodilation of resistance arteries and lowering of blood pressure (in resistant hypertension)

29
Q

What are some future pharmocological options for treating resistant hypertension?

A

Novel aldosterone antagonists

Aldosterone synthase inhibitors

Endothelin antagonists

Direct renin inhibitors

30
Q

What are some future non-pharmocological options for treating resistant hypertension?

A

Renal denervation – especially for patients in which kidneys contribute to the cause

Neurovascular decompensation

Implantable pulse generators

31
Q

How does high BP contribute to Alzheimer’s?

A

High blood pressure can damage small cerebral arteries in the frontal lobe

32
Q

______________ reduced the risk of Alzheimer’s approximately 75%

A

Potassium-sparing diuretics reduced the risk of Alzheimer’s approximately 75%

33
Q

What lifestyle factors can you use to lower the risk of Alzheimer’s?

A

Eat a healthy diet

Maintain a healthy weight

Stop smoking and reduce alcohol intake

Check blood pressure at home

BMS3052 (26 decks)

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