B.3 Hypertension Flashcards
What is blood pressure?
The force exerted by the heart through the arteries (driving force for blood to flow)
What is systolic blood pressure?
The upper value as ventricles are contracting (pressure of arterials when ventricles contract)
What is diastolic blood pressure?
The lower value as ventricles are not contracting but fill
pressure of arterioles when the ventricles are relaxed
What is the mean arterial pressure equal to?
Diastolic +1/3 pulse pressure
What is the pulse pressure?
The difference between systolic and diastolic pressure
What is the standard physicological blood pressure for healthy people (and for young people)
Healthy people: 120/80mmHg
Healthy young people: 100/60 mmHg
What is the blood pressure for prehypertensive patients?
120-139/80-89mmHg
What is blood pressure equal to?
Cardiac output x TPR (total peripheral resistance)
What is cardiac output?
The volume of blood pumped per unit time
What is TPR?
Total peripheral resistance is the resistance to blood flow which is posed by the arterial circulation. (the resistance of the arteries to blood flow)
How does sympathetic activity affect CO and TPR?
Acts on the heart to speed up the force of contraction
Increases TPR via vasoconstriction.
More minute to minute regulation
Blood regulation induced by sympathetic activity is affected minute to minute. True or false?
True
What organ regulates blood flow on a more long term level?
Kidney
What is the traditional approach to measuring a patient’s blood pressure?
Sphygmomanometer with auscultation
What part of the arm is the radial pressure and the brachial pressure found?
Radial artery: wrist
Brachial artery: Inside the elbow
What happens to blood flow when the pressure in the cuff is less than the systolic pressure?
Blood will flow
What happens to blood flow when the pressure in the cuff is greater than the systolic pressure?
Blood will not flow
At what height should the Cluff be placed on the arm and why?
Height of heart so that arterial pressure is central pressure
What happens if the cuff is placed above or below the required height?
The hydrostatic effect is experienced
What will happen if the pressure in the cuff is between systolic and diastolic pressure?
Turbulent flow of blood
When will you hear korotkoff sounds?
When the pressure in the cuff is equal to systolic pressure
when the cuff pressure is equal to diastolic pressure then sounds will disappear
How many phases are there in korotkoff sounds and what are the sounds generated by?
5 phases generated by turbulent flow
What is phase one, 4, and 5?
One: cuff= systolic then tapping
Four: muffling (just above diastole)
Five:
Cuff+ diastolic then sounds disappear
What is white coat hypertension?
Hypertension induced by the stress of visiting the GP leading to false diagnosis (home monitoring and ambulatory devices used for a more realistic picture)
What is essential (primary) hypertension?
Where the cause of hypertension is not known but may be multifactorial
(blood pressure associated with significant cardiovascular risk)
What factors could be multifactorial for essential hypertension
Obesity Insulin resistance Excessive alcohol consumption Genetics Environment Low birth weight Salt sensitivity age Ethnicity
What is isolated systolic hypertension?
Increase in systolic BP with normal diastolic
Associated with age and aorta becomes stiffer (less recoil)
What is the theory of the development of hypertension?
Raise in pressure: - Fluid overload - Increase RAAS - Vasoconstriction Endothelial dysfunction
This leads to an adaptive change:
Remodeling of blood vessels
-Hypertrophy (more muscle) of small arteries to protect capillaries
This leads to an:
- Increased vascular resistance
- Increased reactivity of arteries
- Maintains high blood pressure
What is secondary hypertension and what can it be due to?
Raised blood pressure due to another disease:
- renal disease
- renovascular disease
- conns syndrome
- cushioning syndrome
- hyperthyroidism
- phaeochromaocytoma
- pregnancy
- drugs
What are the consquences of hypertention?
The risk of CVD doubles for every 20/100mmHg increase from 115/75mmHg
- Left ventricular hypertrophy (IHD)
- Increased risk of myocardial infarction
- Increased risk of stroke
- Development of renal impairment
- Development of chronic heart failure
What are the goals of treatment for hypertension?
A reduction of blood pressure and when this involves drug treatment, this should be with as few side effects as possible.
- reduction in cardiovascular damage
preservation of renal function
limitation or reverse of left ventricular hypertrophy
prevention of IDH
reduction in mortality due to stroke and MIs.
