Circulatory Problems Flashcards
HTN epidemic in US
70M Americans have high BP, 30% are pre HTN, “silent killer”, inc risk for heart disease, stroke, and kidney disease
Which race will more often experience HTN?
African Americans. More common that whites and hispanics
Criteria for dx of HTN (> and < age 60)
age >60 BP 150/90
age <60 BP 140/90
those with DM or renal failure goal is <140/90 at any age
5 types of HTN
primary (essential) HTN, secondary HTN, “white coat” HTN, isolated systolic HTN (ISH), malignant HTN
“equations” for vascular regulatory system
CO = SVxHR BP = CO+PVR
CO
cardiac output
SV
stroke volume
HR
heart rate
PVR
peripheral vascular resistance
alterations of the vascular regulatory system (what happens if factors inc/dec?)
inc PVR, HR, or SV = inc BP
dec PVR, HR, or SV = dec BP and can cause dec perfusion to body tissues
location and function of baroreceptors
(w/n carotid sinus) monitor arterial pressure and counteracts rise through vagal response which dec HR and is also vasodilator, can also inc BP when it falls
function of the kidney’s in maintaining body’s homeostasis
regulate body fluid volume by regulating Na+ and H2O, Na+ retention by renin- angiotensin system
vascular autoregulation
keeps perfusion to the tissues constant
cause and risk factors of primary HTN
no known cause Age > 60 Family history of HTN High sodium intake Physical inactivity Excessive alcohol intake Low potassium, magnesium, calcium intake Smoking, Stress, Obesity Hyperlipidemia
cause of secondary HTN
Certain diseases increase susceptibility to hypertension=secondary *anything that regulates BP Renal vascular and renal parenchymal disease Primary aldosteronism Cushing’s disease Coarctation of the aorta Brain tumors Encephalitis Pregnancy Some medications (estrogen, steroids)
“white coat” HTN
with presence of Dr pt’s BP may rise up to 20 pts, but will dec to near normal w/n 10 mins as comfort level inc, retake BP before client leaves
definition of isolated systolic HTN
Diastolic number less than 90 millimeters of mercury (mm Hg) and a systolic number greater than 140 mm Hg
complications of isolated systolic HTN
can lead to serious health problems, such as stroke, heart disease, chronic kidney disease and dementia, and should be treated in the same way as regular high blood pressure
goal of tx of isolated systolic HTN
systolic <140 and diastolic no lower than 70
definition of malignant HTN
Severe form of elevated BP that rapidly progresses
SBP >200 mm HG, DBP >150
or DBP >130 with other complications *need to act quickly on sx
sx of malignant HTN
morning HA, blurred vision, dyspnea, uremia (waste products in the blood)
complications of malignant HTN
May cause stroke, renal failure, left ventricular failure
HTN crisis (urgency)
ACE inhibitors, adrenergic inhibitors, Ca antagonists. BP 180/110 but no target end organs effected, able to adjust meds w/o signs/sx
HTN crisis (emergency)
Vasodilators, adrenergic inhibitors. BP >180/120 and target organs effected
