Chapter 16 - Alterations In Blood Pressure Flashcards
What is blood pressure the product of?
Cardiac output (CO) which is (HR X SV) and systemic vascular resistance (SVR)a
What creates most of the resistance in the vascular system?
Arterioles; changes in the diameter of arterioles profoundly affects SVR and therefore blood pressure.
What is Pulse pressure?
The difference between systolic and diastolic pressure.
What is the MAP?
The average pressure within the systemic arterial system
What may contribute to erroneous blood pressure values?
Missed auscultartory gap
Hydrostatic pressure changes associated with arm position
Inappropriate cuff size,
Observer error
How is blood pressure regulated on a short-term basis?
Short-term regulation primarily involves heart rate and SVR
Carotid and aortic baroreceptors
Vasomotor center in the brainstem
Activation of the SNS and inhibition of the PSNS influences on the heart and smooth muscle in the arterioles.
How is blood pressure regulated on a long-term basis?
nervous system
Release of hormones
Responses of the kidneys to pressure changes
The vasomotor center and activation of Alpha 1 receptors in the smooth muscles of the arterioles AND The Beta 1 receptors of the heart continue to be involved when pressure changes are sensed by the baroreceptors.
What hormones affect fluid balance and what hormone(s) increase SVR
Secretion of ADH in response to osmolarity and aldosterone from the activation of the RAAS affects fluid balance, where as angiotensin II produces an increase in SVR.
What is the etiology of primary hypertension and what are the risk factors?
Primary hypertension has no identifiable etiology.
Risk factors include: dietary factors including excess sodium and obesity; ethnicity and family history; sedentary lifestyle and tobacco use.
When does stage 1 hypertension begin?
What denotes prehypertension?
Systolic 140 or
Diastolic 90
Prehypertension:
Systolic 121-139
Diastolic 81 - 89
What is the treatment of primary hypertension?
Lifestyle modifications and drug therapy.
Lifestyle changes address the “modifiable” risk factors.
Drug therapies target one or more of the variables of blood pressure: HR, SV, SVR
What is unique about secondary hypertension?
It is the result of identifiable pathologic conditions, or certain drugs or foods.
It is the major cause of hypertension in children and is less common in adults.
The underlying cause must be treated.
When does hypertension become symptomatic And what augments symptomatic manifestations?
When it causes significant damage to vulnerable organs or tissues.
This process is augmented by atherosclerosis in the coronary, renal, and cerebral arteries.
What are people at risk for who struggle with hypertension?
stroke, angina, myocardial infarction, heart failure, renal failure, and blindness caused by retinopathy
How are extreme and rapidly developing hypertension classified?
How is each treated?
In to two groups; emergency, where there is evidence of end-organ damaged; and urgency, where there is not.
Urgencies are treated more slowly with oral medications; emergencies require hospitalization and more rapid-acting interventions.
