Arterial HTN Flashcards
This is the most common type of HTN, where the cause of the elevated BP is unknown, as it’s usually attributable to diverse etiologies.
Essential HTN
This the type of HTN where the cause of the elevated BP is due to a definable cause
Secondary HTN
What is the equation to calculate BP (2 values)?
BP = CO*TPR
Does angiotensin II, catecholamines, a1 receptors, endothelin, oxygen, and hematocrit increase or decrease TPR?
Increase
Does B2 receptors, NO, H, and prostaglandins increase or decrease TPR?
decrease
This the phenomenon when an increase in BP leads to an increased urine volume and Na+ excretion, which then lowers the BP to normal.
Pressure natriuresis
This is the stage of blood pressure when the systolic is <80
normal
This is the stage of blood pressure when the systolic is 120-139 and the diastolic is 80-89
Prehypertension
This is the stage of blood pressure when the systolic is 140-159 and the diastolic is 90-99
Stage 1 HTN
This is the stage of blood pressure when the systolic is >160 and the diastolic is >100
Stage 2 HTN
Which ANS pathway can cause essential HTN?
SANS
Increased SANS, certain hormones, and ion channel defects can cause what with blood vessels to cause essential HTN?
Vasoconstriction
What are the 2 problems with the kidney that can cause essential HTN?
- ion channel defect
- inappropriate hormone regulation
all to increase salt and water retnetion
In young adults, is systolic or diastolic HTN more common?
diastolic
What is high in young adults to cause HTN (mainly)?
Cardiac output
In the elderly, is systolic or diastolic HTN more common?
Systolic
Why is systolic HTN more common in the elderly? What causes this?
Increase in TPR –> LV hypertrophy
This is the most common cause of HTN, age of onset is 20-50, family Hx of HTN, normal serum K+ and urinalysis.
Essential HTN
Which factor is elevated in urinalysis with HTN from chronic renal disease?
Creatinine
Primary aldosteronism will cause a decrease in which ion, which u can use as a marker, for HTN?
K+
This is the cause of HTN where there are abdominal bruits, a sudden onset, and a decreased serum K+
Renovascular
This is the cause of HTN where there is paroxysms of palpitations, diaphoresis, headache, weight loss, and episodic HTN.
Pheochromocytoma
This is the cause of HTN when the BP in the arms is > legs or the R arm is > the left atm.
Coarctation of the aorta
This is the cause of HTN associated with central obesity and hirsutism.
Cushing syndrome
What does oral contraceptives, glucocorticoids, cyclosporine, and sympathomimertic drugs act on to cause secondary HTN?
Renin-angotensin system
How does erythopoietin (EPO) cause secondary HTN?
increases blood viscosity
What does NSAIDs do to the kidney to cause secondary HTN?
Na and water retention
Which ANS pathway does ethanol and cocaine act on to cause secondary HTN?
SANS
Why do damaged nephrons cause secondary HTN?
unable to secrete normal amts of Na and water
Which 3 conditions cause secondary HTN by causing the kidney to release renin?
arteriosclerosis, fibromuscular dysplasia, and coarctation of the aorta
This is the condition where there is an adrenal adenoma or bilateral hyperplasia of the adrenal gland to cause hyperaldosteronemia and low renin levels.
Primary aldosteronism
This is the generic rearrangement in which the aldosterone synthesis abnormally comes under the regulatory control of the adrenocorticotropic hormone (ACTH)
Glucocorticoid-remediable aldosteronism (GRA)
This is the condition where there is increased angiotensin II production from a rare renin-secreting tumor, women taking oral contraceptives, or impaired AGII degredation in liver diseases.
Secondary aldosteronism
Glucocorticoids can stimulate which system to cause HTN?
renin angiotensin system
Which thyroid abnormality (hyper or hypothyroidism) can cause disastolic HTN by increasing TPR by SANS and adrenal activation?
Hypothyroidism
How can hyperthyroidism cause HTN?
cardiac hyperactivity with an increase in blood volume
We keep talking about this renin-angiotensin-aldosterone system (RAAS), but we need to figure it out. Where is renin secreted from?
juxtaglomerular cells of the afferent arteriole of the Kidney
Renin acts like an enzyme to cause angiotensinogen to be converted to what?
Angiotensin I
Which enzyme converts angiotensin I to angiotensin II?
ACE
What is the role of angiotensin II on the arterial smooth muscle?
vasoconstriction
What is the role of angiotensin II on the adrenal gland?
increase aldosterone
How does aldosterone cause HTN?
increases renal Na+ reabsoption
What is the role of angiotensin II on the SANS?
facilitates release of NE
What is the role of angiotensin II on the kidney?
increase renal tubular Na+ reabsorption
What is the role of angiotensin II on the brain?
Stimulates thirst and vasopressin secretion
What is the role of angiotensin II on the heart?
Enhances contractility and ventricular hypertrophy
In what way does low BP cause renin release from the juxtaglomerular cells of the afferent arteriole?
decrease in renal perfusion Pressure
Which ion is the main factor in maintaining fluid levels?
Na+
This type of arteriolosclerosis shows homogenous, pink hyaline thickening with associated luminal narrowing.
Hyaline artiolosclerosis
How does HTN cause hyaline arteriolosclerosis?
plasma protein leakage across injured endothelial cells
This type of arteriolosclerosis shows onion skin lesions and fibrinoid necrosis
Hyperplastic arteriolosclerosis
How much does HTN increase your risks for cardiovascular disease for each 20/10mmHg increase?
Doubles it per increase
Elevated belly fat, high triglyceride levels, low HDL, HTN, and elevated fasting glucose all contribute to what syndrome?
Metabolic syndrome
Intake of what ion causes HTN?
Sodium
What % of HTN pts are salt-sensitive?
50-60%
Low levels of what ion in the blood stimulates renin secretion, leading to HTN?
K+
What food can u eat to maintain normal K levels?
Fruits and veggies and meats and milk and my anus
Why do physicians recommend some dairy and milk for HTN pts? What ion are they looking at, which helps maintain normal BP?
Ca++
This substance directly increases arterial pressure and can contirbute to stroke upon intake.
Alcohol
People with what condition have a 2-6 fold increase of risk of developing HTN by increasing salt-sensitivity?
Obesity
Taking this at least once a week could cut the chances in half of dying suddenly from heart failure due to an atherosclerotic thrombus.
Omega-3 FA’s
In what 2 ways does omega-3 fatty acids reduce the risk of thrombus formation?
- inhibit blood platelet aggregation and clot formation
2. prevent plaque formation in coronary arteries
Which vitamin controls the production of proteins that are involved in blood clot formation?
vitamin K
Potassium keeps what ion in the bone, thus preventing the buildup in the arteries and therefore arterial calcification?
Ca++
The inadequate intake of folate, B12, B6, or riboflavin can cause impaired metabolism of what susbtance, which is an important cardiovascular risk factor?
Homocysteine
Elevated homocysteine levels can cause the increase in which vascular mediator?
NO
