6 - Hypertension

Question 1

Blood Pressure equation

Answer 1

Cardiac output x SVR

Question 2

Optimal BP

Answer 2

120/80

Question 3

Normal BP

Answer 3

130/85

Question 4

Grade 1 hypertension

Answer 4

140-159/90-99

Question 5

Grade 2 hypertension

Answer 5

160-179/100-109

Question 6

Grade 3 hypertension

Answer 6

> 180/>110

Question 7

Hypotension

Answer 7

SBP <90mmHg

DBP <60mmHg

Question 8

Postural Hypotension

Answer 8

SBP decrease in standing >20mmHg or DBP >10mmHg

Question 9

Symptoms of hypotension

Answer 9

Dizziness
Impaired cognition
Lethargy
Fatigue 
Angina

Question 10

Hypertension

Answer 10

systolic is persistently >140 and diastolic persistently >90 mm Hg

Question 11

Diagnose hypertension

Answer 11

Repeat BP measurements on separate occasions

24 hour BP monitoring

Question 12

Concentric hypertrophy

Answer 12

size of the ventricle chamber decreases
To maintain cardiac output the heart rate must increase.
HT can cause this

Question 13

Eccentric hypertrophy

Answer 13

whole ventricle enlarges (and the wall may or may not increase in thickness). The enlarged heart is weaker and this can lead to heart failure

Question 14

Signs of damage to the retina caused by hypertension

Answer 14

Silver/copper wire arterioles - centre of arterioles shine due to reflected light
Micro aneurysms, swelling of optic disk

Question 15

Secondary causes of hypertension

Answer 15

5% of all cases
Renal disease
Cushings syndrome
Endocrine disease
NSAIDs
Thyroid disease

Question 16

What % of hypertension is primary

Answer 16

95%

Question 17

How is BP usually controlled

Answer 17

1) Baroreceptors in carotid artery

2) RAAS system

Question 18

Where is the arbitrating mechanism located and what is it’s funciton

Answer 18

Medulla

Relieve conflicts between two control systems

Question 19

Which BP control system is chronic hypertension associated with

Answer 19

RAAS

- elevated renin and angiotensin II

Question 20

Why is dietary salt restriction part of hypertension treatment

Answer 20

high renin and angiotensin levels lead to excess sodium retention

Question 21

Why are diuretics part of the hypertension treatment

Answer 21

high renin and angiotensin levels lead to retention of water (via raised ADH)

Question 22

Hyponatremia

Answer 22

EC fluid Na+ is below 135mmol/L
Normal (135-145mmol/L)
can cause brain swelling

Question 23

Symptoms of hyponatremia

Answer 23

Loss of energy, fatigue, confusion, muscle weakness

Severe - nausea, vomiting, headaches, spasms, restlessness,seizures, coma

Question 24

Why do a majority of diabetes patients have hypertension

Answer 24

diabetes damages the kidneys and induces excess renin release

Question 25

Why does obesity cause hypertension

Answer 25

Obesity increases renal renin release, angiotensin formation and sodium retention

High levels of leptin (due to increased number of fat cells) increase sympathetic vasoconstriction

Question 26

Treatment for hypertension

Answer 26

1) Lifestyle changes - exercise and diet
2) Thiazide diuretic e.g bendroflumethazie
3) Diuretic + BB or ACE inhibitor
4) Angiotensin receptor blocker
5) Calcium channel blocker
(ABCD

Question 27

Systolic BP

Answer 27

Maximum BP during ventricular contraction

Question 28

Diastolic BP

Answer 28

Minimum level of BP measured between contractions of the heart