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EXB 117 MIDTERM > 7-8. Hypertension > Flashcards

7-8. Hypertension Flashcards

1
Q

What part of the brain controls blood pressure?

A

Brainstem

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2
Q

What is the primary cause of hypertension? 2 mechanisms by which this occurs?

A

Imbalance b/t cardiac output and arterial resistance:

  • increased afterload (heart pumping too hard for vessels)
  • arterial damage (vessels too small to handle blood pumped out)
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3
Q

What is hypertension?

A

Excessive tension in the arterial tree

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4
Q

Which BP is observed when the aortic valves is open? Closed?

A
  • Open = SBP

- Closed = DBP

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5
Q

What factors affect SBP?

A
  • HR
  • Contractility
  • Aortic elasticity
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6
Q

What factors affect DBP?

A

Things that affect the arterioles

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7
Q

How many BP readings are needed in order to make a clinical diagnosis?

A

3 sets of readings at least 1 week apart, unless severe

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8
Q

What is the drainage rate when taking a BP?

A

2-3 mmHg/sec

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9
Q

What is the range of normal BP?

A
  • SBP less than 120

- DBP less than 80

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10
Q

What is the range for prehypertension?

A

120-139/80-89

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11
Q

What is the range for stage 1 hypertension?

A

140-159/90-99

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12
Q

What is the range for stage 2 hypertension?

A

160+/100+

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13
Q

How is a person w/ hypertension categorized?

A

The higher of SBP or DBP

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14
Q

Which CVD is known as “the silent killer”? Why?

A

Hypertension b/c asymptomatic for years to decades

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15
Q

What is the prevalence of hypertension in U.S. adults?

A

60 million

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16
Q

What fraction of U.S. adults under age 65 have hypertension?

A

1/4 - 1/3

17
Q

What fraction of U.S. adults over age 65 have hypertension?

A

1/2

18
Q

What is the leading reason in the U.S. for physicians visits and prescriptive meds?

A

Hypertension

19
Q

What are the end organ consequences of hypertension?

A
  • Heart: LV hypertrophy, congestive heart failure, MI, ischemia
  • Stroke
  • Aortic aneurysm or dissection
  • Renal failure
  • Retina: hemorrhage, blindness
20
Q

1° vs. 2° hypertension? What % of hypertension does each account for?

A 
PRIMARY:
-90-95% of all cases
-unknown or multiple causes
SECONDARY:
-5-10% of all cases
-hypertension caused by another pathology
21
Q

Which type of hypertension (1° or 2°) is more common in younger peeps?

A

2°

22
Q

What are the causes of 2° hypertension?

A
  • Renal disease
  • Coarctation of the aorta
  • Endocrine abnormalities (hyper or hypothyroidism)
  • Meds (estrogens, androgens, cocaine)
23
Q

What is aortic coarctation? Where does it occur? Effect?

A
  • Aorta is pinched and narrow
  • Often @ the site of the now-closed ductus arteriosus
  • BP above coarctation is elevated while BP below is lowered
24
Q

What is Poiseuille’s Law?

A

Q = ∆P/R

25
Q

How does insulin effect hypertension?

A

Hyperinsulinemia (elevated insulin in blood) may be a unifying factor in many cases of essential hypertension

26
Q

What are the mechanisms by which hyperinsulinemia may increase BP?

A

Increased:

  • renal sodium reabsorption
  • sympathetic activation
  • arterial smooth muscle cell hypertrophy
  • intracellular calcium and vascular tone
27
Q

What are the lifestyle interventions used to treat hypertension?

A
  • Weight loss
  • Diet (sodium and alcohol restriction)
  • Exercise
28
Q

What are the pharmacological interventions used to treat hypertension?

A
  • Diuretics
  • Beta blockers
  • Vasodilators
  • Calcium channel blockers
  • RAS blockers (ACE inhibitors, Angiotensin receptor blockers)
29
Q

Which lifestyle intervention usually produces the best outcomes for lowering BP?

A

Weight loss (5-20 mmHg for every 22 lbs lost)

30
Q

What are the mechanisms by which exercise improves hypertension?

A
  • Decreased blood viscosity
  • Increased arterial elasticity
  • Decreased sympathetic nervous activity
  • Lower insulin levels
  • Preservation of endothelial function
  • Reduced vascular resistance
  • Altered baroreceptor sensitivity or CNS regulation of BP
  • Weight management
31
Q

How do ACE inhibitors manage hypertension?

A

Inhibit angiotensin converting enzyme –> angiontensin I doesn’t convert to angiotensin II –> no vasoconstriction –> no increase in BP

32
Q

How do angiotensin II blockers manage hypertension?

A

Inhibit angiotensin II from vasoconstricting –> no increase in BP

33
Q

What is the recommended frequency, intensity, duration and mode of exercise for patients w/ hypertension?

A
  • Frequency = 3 days/week
  • Intensity = 50-65% HRmax
  • Duration = 30+ mins
  • Mode: aerobic, circuit weight training @ less than 60% 1RM
34
Q

What types of exercise create the greatest dangers for a poorly controlled hypertensive?

A

Weight lifting greater than 60% 1RM

EXB 117 MIDTERM (4 decks)

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