Chronic Cardiovascular Diseases Flashcards
What is hypertension?
= raised BP
What are Systolic and Diastolic values for patient with hypertension?
= Systolic, >140mmHg
= Diastolic, >90mmHg
How do you diagnose high blood pressure?
= 3 separate measurements, sitting and rested
What are the risk factors for hypertension?
= age
race
obesity
alcohol
family history
pregnancy
stress
drugs (non steroidal, corticosteroids, oral contraceptives)
Which condition causes the biggest risk of hypertension?
A stroke= cerebrovascular accident
Name some of the key outcomes from Hypertension
= accelerated atherosclerosis
- MI
- Stroke
-Peripheral vascular disease
= renal failure (blood flowing at higher pressure and will damage the vessels which lead to the kidneys)
What are the common triggers of hypertension?
= None are usually found
=likely genetic failure of autoregulation of blood vessel wall constriction
Name some rare triggers for hypertension
= renal artery stenosis
= endocrine tumours
- phaeochromocytoma (adrenaline)
- conn’s syndrome (aldosterone)
- cushing’s syndrome (cortisol)
What is adrenaline ?
= a vasoconstrictor
how do aldosterone and cortisol work?
= increase circulating blood volume
what are the common signs and symptoms for hypertension?
= usually NONE
= may get headache
= may get transient ischaemic attacks (temporary disruption in the blood supply to part of the brain)
How does a phaemochromocytoma result in hypertension?
causes the adrenal gland to produce too much adrenaline therefore increasing a patients BP
How does cushing’s syndrome cause hypertension?
ACTH (adrenocorticotropic) tells the adrenal gland to make more cortisol
How does Conn’s syndrome cause hypertension?
= the adrenal glands make too much aldosterone
what some indications for further investigation (hypertension)?
= if the patient is young
= resistant hypertension despite adequate treatment
= accelerated hypertension
= ‘unusual’ history
What does cushing’s syndrome cause?
= salt and water retention
= leads to excess fluid within circulation
How can renal artery stenosis cause hypertension?
= narrowing of the blood flow into the kidney
= the kidneys think the BP has dropped therefore will produce aldosterone which will rapidly increase BP
How is renal artery stenosis treated? (medication)
ACE inhibitors
What do ACE inhibitors do in relation to renal artery stenosis?
Blocks angiotensin (enzyme causing arteries to narrow)
= widen the blood vessels to improve blood flow
What are the investigations for hypertension?
= urinalysis
= serum biochemistry
= serum lipids
= ECG
what is the ideal BP which hypertensive patients should aim for?
< 120/90 mmHg
Which risk factors should be modified when treating hypertension?
= weight loss
= exercise
Which drugs might you prescribe a patient to take once daily and why might you do this?
= thiazide diuretic
= beta blocker
calcium channel antagonists
ACE inhibitors
increase patient compliance
How often should you monitor a patient with hypertension?
= review at least annually when stable as the treatment will change overtime
What is simple definition of heart failure?
output of the heart is incapable of meeting the demands of the tissues
What is high output failure and give 2 examples
= demands of the system have increased beyond the capacity of the pump
= anaemia and thyrotoxicosis
What is low output failure and give an example
pump is failing and not strong enough to force liquid around the body
= cardiac defect e.g. MI, valve disease
What side of the heart does most of the work
LEFT
Difference between diastole and systole
diastole = filling
systole = pumping
What is the aetiology of low output failure?
= heart muscle disease
= pressure overload
= volume overload
= arrhythmias
= Drugs
Name 2 causes of heart muscle disease?
= MI
= Myocarditis
Name 2 conditions which involve pressure overload?
= hypertension
= aortic stenosis