chapter 31: hypertension Flashcards
arterial blood pressure (definitions)
Systolic pressure: height of pressure pulse
Diastolic pressure: lowest pressure (relaxed)
Pulse pressure: difference between systolic and diastolic
Mean arterial pressure: represent the average pressure in the arterial system during ventricular contraction and relaxation
Factors influencing mean arterial blood pressure
PHYSICAL:
-blood volume and the elastic properties of the blood vessels
PHYSIOLOGIC FACTORS:
- cardiac output
- peripheral vascular resistance
Most common causes of secondary hypertension
KAPCS
- kidney disease (renovascular hypertension)
- adrenal cortical disorders
- pheochromocytoma
- coarctation of the aorta
- sleep apnea
Factors determining systolick and diastolic
SYSTOLIC
- stroke volume being ejected from the heart
- the ability of the aorta to stretch and accommodate the stroke volume
DIASTOLIC
- Energy that is stored in the aorta as its elastic fibers are stretched during systole
- the resistance to the run off of blood from the peripheral blood vessels
arterial blood pressure
- Represents the pressure of the blood as it moves through the arterial system
- CO=HR x SR
- vascular resistance
- mean arterial pressure = CO x VR
Mechanisms of BP regulation
SHORT-TERM REGULATION: corrects temporary imbalances in blood pressure
- neural mechanisms
- humoral mechanisms
LONG-TERM REGULATION: controls the daily, weekly, and monthly regulation of blood pressure
-renal mechanism
Korotkoff sounds
- PHASE 1: marked by the first tapping sounds, which gradually increases intensity
- PHASE 2: period in which a murmur or swishing sounds is heard
- PHASE 3: period during which sounds are crisper and greater in intensity
- PHASE 4: period marked by distinct abrupt muffling or by a soft blowing sounds
- PHASE 5: point at which sounds disappear
Joint national committee on detection, evaluation, and treatment of hypertension
- normal: 120/80
- prehypertensive: 139/89
- hypertension: >140/90
- diabetes mellitus: 130/80
categories of hypertension
- PRIMARY HYPERTENSION: (essential hypertension) chronic elevation in BP that occurs without evidence of other disease
- SECONDARY HYPERTENSION: elevatino of BP that results from some other disorder, such as kidney disease
- MALIGNANT HYPERTENSION: accelerated form of hypertension
- SYSTOLIC HYPERTENSION: systolic is great than 140, but diastolic is less than 90
classificatinos of essential hypertension
- systolic/diastolic hypertension: both is high
- diastolic hypertension: diastolic is high
- systolic hypertension: systiloc is high
risk factors for hypertension
-family history, age, race, insulin resistance and metabolic abnormalities, circadian variations, lifestyle factors
lifestyle factors contributing to hypertension
high salt intake, obesity, excess alcohol consumption, dietary intake of potassium, calcium, and magnesium, oral contraceptive drugs, stress
factors affecting hypertension
- Age: more commin in younger men and elderly
- Race: more common in blacks than whites
- Socioeconomic group: More common in lower socioeconomic groups
Target organ damage
- The heart: hypertrophy
- Brain: dementia and cognitive impairment
- Peripheral vascular: atherosclerosis
- Kidney: Nephrosclerosis
- Retinal complications
Factors affecting treatment strategies for hypertension
The person’s lifestyle, demographics, motivation for adhering to the drug regimen, other disease conditions and therapies, potential for side effects
