Build and Blood pressure Flashcards
how is BMI calculated?
(lbs/height in inch/height in ich) x 703
(KG/ height in meters)^2
what range of BMI is overweight? obesity (1,2,3)?
overweight (25-29.9)
obese grade 1- 30-40
what age is more common for obesity ?
middle aged (40-59)
what are 7 contributors to raising obesity rates among the population?
- physical inactivity
- food selection (larger portion sizes, and more choices)
- age
- gender (men have higher metabolic rates)
- genetic factors
- behavioural and psychological factors
- medical factors.
how is waist circumference used in uw?
measure of abdominal fat. men with 40 inch or more, and women with 35 inch or more are considered at risk.
whats is WHR and how is it implied in UW?
its the waist- to - hip ratio. If its of 1.0 or higher, the individual is considered of increased risk.
what are the cons of medications in terms of weightloss?
medications such are Orlistat, which is FDA approved has been associated with severe liver injury. drugs such as deitlylpropions and phentermines are effective for short-term byt have potential use for abuse.
supplements are not proven effective and can have significant adverse effects.
how is surgery used for the treatment of obesity?
bariatric surgery tx by altering the digestive process and generally is either restrictibe, malabsorptive or both.
what is generally the most successful type of weightloss surgery?
malabsorptive tends to be more successful than restrictive. A.E. rarely common.
what is the most common restrictive procedure in weightloss surgery?
LAGB (laproscopic adjustable gastric banding)»_space; makes stomach smaller by banding it at the top with an elastic. the band is tightened with salt solution.
Name 2 other restrictive procedure besides LAGB?
LSG laproscopic sleeve gastrectomy»_space; removes a portion of the stomach. This has also proben to be as effective as a gastric bypass.
VBG verticle banded gastroplasty»_space; uses band and staples to create a smaller stomach.
what is a con of restrictive surgery?
associated with GERD, and recurrent vomitting, band erosion, slippage or leakage of salt solution, nutritional deficiences, breakdown of staple lines.
what is the most common malabsorptive surgery?
Roux-en-Y gastric bypass RYGB»_space; portion of the digestive ttact that absorbs calories and nutrients is bypassed.
what is a BPD?
biliopancreatic division involves removing portions of the stomach and connecting a small remaining stomach pouch to the ileum - bypasses dudenum and jejenum.
what is a dudenal switch?
resembles BPD but leaves larger portion of the stomach intact and keeps small part of the duodenum.
a client who underwent malabsorptive surgery will require what in their daily intake?
supplements and vitamins to prevent nutritional deficiencies, anemia and osteoporosis.
what is a possible side effect to malabsoptive surgery post-op?
dumpling syndrom, intestinal obstruction, hernia, and gastrointestinal bleeding and ulcerations.
how many deaths per year are associated with obesity and the USA?
100K
obesity is likely to aggravate what type of common diseases?
T2DM, IGT, CAD, CHF, HTN, stroke, metabolic syndrome, ^ cholesterol, sleep apnea, depression, cancers and osteroarthritis. Accidents and injuries, and longer recovery.
Low BMI in any age group can be a marker for which type of diseases?
cancer, T1DM, intestinal malabsorption, depression, anorexia, bulimia, drug or alcohol abuse, or hyperthyroidism.
how are older individuals influenced by underweight and overweight BMI’s?
being overweight is actually protective in older individuals. weight loss of more than 5% over 65 is associated with increased morbidity.
describe BP
the consequence of the interaction between pressure required to move blood through the blood vessels (cardiac out put) and the tone or tension of the arteries (peripheral resistance)
what two measurements are used in measure in blood pressure?
systolic blood pressure (SBP) and diastolic blood pressure
what is pulse pressure?
is the difference between SBP and DBP
what are some factors that can increase BP?
physical exertion, anxiety, smoking, caffeine, alcohol, drugs.
what is the range for normal BP? pre-hypertension? stage 1-hypertension? stage 2 hypertension?
normal 120/80
pre-HTN 120/80 - 139/89
stage 1-HTN 140/90= 159/99
stage 2-HTN 160100
what is primary hypertension?
essential or idopathic, no identifiable cause, and accounts for 95% if hypertension.
what is secondary hypertension
accounts for 5% of cases, due to underlying disease or external cause.
what is white-coat hypertension
high readings in the physicians office with normal readings in other settings
what is systolic hypertension ?
systolic BP >140, diastolic
pseudo-hypertension
inaccurate ^ reading in the elderly due to stiff, calcified arteries or in the obese due to a BP cuffs that is too small
what is borderline hypertension
BP in the high range of normal
what is resistant hypertension?
inadequate BP control despite the use of three or more anti-hypertensive drugs.
what is ambulatory blood pressure monitoring?
monitoring BP over a 24 hour period of time
what are additional investigations to determine possible second causes of HTN?
fundoscopic exam, electrocardiogram, echo, blood evaluations, urinalysis, renal evaluations, special studies including urine and plasma catecholamines.
what are the treatment options for hypertensions?
- lifestyle
2. medications
name 8 drugs used to treat HTN
- thiazide diuretics (HCTZ) -
- Calcium channel blockers (amlodipine, felodipine, diltiazem)
- ACE inhibitors (enalapril, ramipril, and lisinopril(
- beta blockers (atenolol and metoprolol)
- ARB’s (losartan and valsartan)
- alpha blockers (doxazosin, and terazosin)
- vasodilators (hydralazine, and methyldopa)
- renin inhibitors (aliskiren)
what are some complications of high blood pressure
L ventricular hypertrophy myocardial infarctions/ischemia arterial fibrillation Carotid artery stenosis proteinuria peripheral vascular disease congestive heart failure CAD arterial aneurysms stroke renal insufficiency/failure cognitive impairment
what is hypotension?
low blood pressure, systolic
what is postural or orthostatic hypotension?
is defined as drop in systolic BP of 20 or a drop in diastolic of 10, or more upon standing from supine position.
what are symptoms of hypotension?
dizziness, syncope, and blurred vision
what are some factors that can cause chronic postural hypotension?
- disorders of the ANS, (parkinsons, diabetic, alcoholic, neuropathy, MS, chronic renal or liver diseases)
- other diseases, including aortic stenosis, pericarditis and myocarditis
- A.E. of certain drugss
how is hypotension treated?
through tx the underlying cause. it can contribute to falls and fractures, and can limit activities of older people.
