Chapter 23: Disorders of Blood Pressure Regulation Flashcards
What is systolic pressure?
pressure at the height of the pressure pulse, the stroke volume ejected from the heart, the aorta stretches
What is diastolic pressure?
the lowest pressure, energy stored in the aorta’s elastic fibers, and resistance to blood flow from the peripheral blood vessels
what is pulse pressure?
the difference between systolic pressure and diastolic pressure
what is the mean arterial pressure?
the average pressure in the arterial system during ventricular contraction and relaxation
What is involved in short term regulation of blood pressure?
the correction of temporary imbalances through neural mechanisms like baroreceptors and chemoreceptors that can cause vasoconstriction or vasodilation, and humoral mechanisms like the RAAS pathway and vasopressin (ADH) that encourage water resorption
What do baroreceptors and chemoreceptors do?
regulate temporary imbalances in blood pressure by causing vasoconstriction and vasodilation
What is involved in long term regulation of blood pressure?
renal mechanisms
What is circadian regulation of blood pressure?
the daily variations in blood pressure depending on the time of day – lowest in the morning and rises as the day goes on
For a diagnosis of HTN what does your blood pressure need to be?
systolic over 140 and diastolic over 90
For a diagnosis of pre-hypertension what does your blood pressure need to be?
systolic between 120-139 and diastolic between 80-89
What is hypertension blood pressure for someone with diabetes?
130/80
What is essential hypertension?
primary hypertension - chronic elevation in blood pressure from no other cause, generally due to modifiable and non-modifiable risk factors
what are non-modifiable risk factors?
things you cannot correct yourself like family history, age, race
What are modifiable risk factors?
things you can change like smoking, drinking, weight, diet, stress, high salt intake, sedentary lifestyle…
What are the target organs for damage in essential hypertension?
the heart, kidneys, brain, peripheral vascular, retina
What are heart complications in essential hypertension?
hypertrophy: the heart has to work harder due to the increase in resistance so it starts to expand and add more muscle to combat the increase in resistance
What are brain complications in essential hypertension?
dementia and cognitive impairment
What are peripheral vascular complications from essential hypertension?
atherosclerosis
what are kidney complications from essential hypertension?
nephrosclerosis – damage to the capillaries in the kidneys
What are retinal complications from essential hypertesnion?
aneurysms, hemorrhage in retinal blood vessels
What is the treatment for essential hypertension?
lifestyle changes, pharm agents like diuretics, beta blockers, ACE inhibitors ARBs, Calcium channel blockers, vasodilators
What is secondary hypertension?
elevation of blood pressure from another disorder
What causes secondary hypertension/what are the conditions it occurs with?
kidney disease (most common), adrenal cortical disorders, pheochromocytoma, oral contraceptives
Why can secondary HTN occur during kidney disease?
due to renal artery stenosis due to atherosclerosis
Why can secondary HTN occur during adrenal cortical disorders?
you are producing too much aldosterone = higher absorption of sodium and water = high BP
why can secondary HTN occur during pheochromocytoma?
it is an adrenal tumor that causes the release of catecholamines that increase HR and increase BP
What are the hypertension disorders that occur during pregnancy?
gestational hypertension – occurs after 20 weeks gestation
chronic hypertension – if you had it previous to pregnancy
preeclampsia – HTN, and can lead to clotting disorders, delivery is the only cure
How do you treat HTN during pregnancy?
early prenatal care, refraining from alcohol and substance use, salt restriction, bed rest, antihypertensive meds (carefully chosen) or delivery
Is primary or secondary HTN more common in children?
secondary
What secondary HTN conditions can cause HTN in children?
kidney abnormalities, coarctation of the aorta – narrowing of the aorta going into the abdomen so it causes blood to back up, and pheochromocytoma
What is orthostatic HTN?
abnormal decrease in bp when standing up
What does orthostatic HTN cause?
decrease venous return due to pooling of blood in extremities, decrease in cardiac output
What causes orthostatic HTN?
things that decrease vascular volume like dehydration
conditions that impair muscle pump function like spinal cord injuries or bed rest
conditions that interferes with cardiovascular reflexes like certain meds, or disorders of the ANS
What is the treatment for orthostatic HTN?
removing underlying cause
avoiding diuretics
drugs that increase bp
consuming more salt
