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Week 1 - Hypertension > Control of Hypertension > Flashcards

Control of Hypertension Flashcards

1
Q

Describe characteristics of an artery.

A

Muscular and elastic.

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2
Q

Describe a characteristic of arteriole.

A

Muscular

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3
Q

Describe the walls of a capillary.

A

Thin-walled

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4
Q

How muscular is a venue?

A

Slightly muscular

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5
Q

What are the primary functions of the venous system?

A

Acts as conduits and reservoirs for blood storage and transport.

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6
Q

Define Heart Rate (HR).

A

The number of times the heart beats per minute (normally 60-85 bpm at rest).

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7
Q

What is Stroke Volume (SV)?

A

The volume of blood ejected from the heart in one beat (around 70 mL at rest).

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8
Q

How do you calculate Cardiac Output (CO)?

A

CO = HR × SV. It’s the volume of blood ejected from the heart per minute (about 5L at rest).

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9
Q

What is Mean Arterial Blood Pressure (MABP) and how is it calculated?

A

MABP is the average pressure exerted on arterial walls. It’s around cardiac output × peripheral resistance.

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10
Q

What factors affect arterial blood pressure?

A

Stroke volume, ventricular contraction, artery elasticity, and peripheral resistance.

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10
Q

What is stroke volume also known as?

A

Circulatory volume

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11
Q

When does the MABP reach 0mmHg?

A

As blood throughs through the vasculature as it enters the right atrium.

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12
Q

How would you describe the behaviour of arteries in response to pressure?

A

Compliant - smoothing pressure out as you go through arterial tree - decreasing pressure

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13
Q

What is the order of arterial tree?

A

Aorta, arteries, arterioles, capillaries, venues, veins, vena cava

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14
Q

What happens if the arteries aren’t compliant?

A

Too much pressure - causing them to burst

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15
Q

What are factors that affect resistance?

A

Viscosity of blood, length of blood vessel, radius/diameter of artery

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16
Q

What is the primary determinant of vascular resistance?

A

The radius/diameter of the artery, which has a major influence on resistance according to Poiseuille’s law.

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17
Q

What role do arterioles, capillaries, and venules play in vascular resistance?

A

These vessels play the biggest role in controlling vascular resistance.

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18
Q

When is the cross-sectional area greatest?

A

Capillaries

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19
Q

What is important regarding to arteriole smooth muscle?

A

Tone

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20
Q

In which capillary tree is velocity of blood flow greatest?

A

Aorta - arteries - arterioles

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21
Q

Why does the velocity decrease whilst cross-sectional areas increase?

A

To facilitate exchange

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22
Q

Why is the cross-section greatest in the capillaries?

A

Due to large amounts of gaseous exchange

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23
Q

What picks up velocity of blood flow?

A

Vena cava picks up velocity to return the blood to the heart

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24
Q

Spotter Question: How to identify between vein vs artery

A

Vein has a larger diameter and is less muscular

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25
Q

What is the Baroreceptor Reflex?

A

A mechanism that regulates heart rate in response to changes in blood pressure via baroreceptors.

26
Q

What does the cardiovascular centre do?

A

Regulates heart rate in response to increased blood pressure

27
Q

What does the sino atrial node regulate?

A

Heart rate - effectively pacemaker of the heart

28
Q

Where do CVS signals go to?

A

Cardiac accelerator nerve

29
Q

What happens during atrial stretch in response to increased venous return?

A

When venous return is raised - wall right atrium stretch - the atrial myocytes in the atrium releases atrial natriuretic peptide (ANP), leading to vasodilation and increased Na+ excretion (water follows), inhibits secretion of ADH - lowering blood pressure.

30
Q

What are the stages of hypertension according to NICE?

A

Stage I: 140/90 to 159/99 mmHg
Stage II: 160/100 to 179/119 mmHg
Stage III: 180/120 mmHg or higher.

31
Q

What are the two types of hypertension?

A

Primary - no single cause
Secondary - another underlying disease causing elevated blood pressure

32
Q

What are the values for AMPB hypertension?

A

135/85 - 149/94 mmHg

33
Q

What are modifiable risk factors for hypertension?

A

Aerobic exercise, weight management, smoking cessation, diet, and stress management.

34
Q

How does exercise affect cardiac output and blood pressure?

A

Exercise increases heart rate and stroke volume, raising cardiac output and temporarily increasing blood pressure.

35
Q

How can malfunctioning ion channels cause damage?

A

Malfunctioning ion channels and pumps in the peripheral vasculature (small artierioles)
Can lead to chronically increased vascular tone
Raises vascular resistance to flow

36
Q

What are endocrine signalling?

A

Adrenaline
Antidiuretic hormone (ADH, vasopressin)
Atrial natriuretic peptide (ANP)
Renin-angiotension-aldosterone system

37
Q

Where and when is adrenaline released?

A

Released from adrenal medulla in response to lowered blood pressure.

38
Q

How does adrenaline reduce blood pressure?

A

Two ways:
Speeds heart rate and force of ventricular contraction - makes heart work harder increasing blood pressure.
Dilated skeletal muscle and constricts splanchnic (mesenteric) vascular bed - moves blood to the muscle.

39
Q

Does adrenaline have an affect on arterial blood pressure?

A

No, but does increase cardiac output and systolic blood pressure.

40
Q

What are antidiuretic hormones?

A

AKA vasopressin
Makes kidneys produce urine with less water

41
Q

Where are antidiuretic hormones released from and when?

A

Posterior part of pituitary in response to decreased blood pressure and increased plasma osmolarity.

42
Q

What slows the release of antidiuretic hormones?

A

Ethanol / alcohol

43
Q

What are the two mechanisms of antidiuretic hormones?

A

Promotes reabsorption of water in kidney
Constricts blood vessels if present at high concentration.

44
Q

How do antidiuretic hormones keep blood pressure up?

A

Increase SV and TPR

45
Q

What are the side effects of antidiuretic hormones?

A

Associated with nocturia and poor sleep
Poor sleep risk factor already for hypertension
Inappropriate or prolonged use in elderly is not an intervention

46
Q

What is the Renin-Angiotensin-Aldosterone System (RAAS)?

A

A hormone system that regulates blood pressure by increasing blood volume and constricting blood vessels through renin and aldosterone actions.

47
Q

Where is renin released?

A

In walls of afferent arterioles of kidney glomeruli.

48
Q

When is renin produced?

A

In response to lowered kidney perfusion pressures caused by other things - eg. lowered blood pressure

49
Q

How does renin work?

A

Acts on a protein called angiotensinogen (protein in circulation, but inactive) and cleaves precursor at specific sites to form angiotensin I

50
Q

What happens to angiotensin I?

A

Converted to angiotensin II

51
Q

What does angiotensin II do?

A

Raises blood pressure more than I

52
Q

What is the enzyme for conversion of angiotensin I to II?

A

angiotensin converting enzyme ACE

53
Q

What do ACE inhibitors do?

A

Block conversion of I to II - blocks blood pressure raising effect

54
Q

What can angiotensin II turn into?

A

Angiotensin III by action of aminopeptidase cleaving off the N-terminal aspirate residue

55
Q

What does angiotensin-aldosterone do?

A

Dispogenic - thirst
Stimulated ADH secretion

56
Q

What is the ratio of angiotensin II and III?

A

5:1

57
Q

What do angiotensin II and III do?

A

Stimulate production in the activate cortex
Stimulate production in the activate cortex
Activate aldosterone secretions from adrenal cortex

58
Q

How does Atrial Natriuretic Peptide (ANP) lower blood pressure?

A

Promotes Na+ and water excretion, inhibits ADH and aldosterone secretion, and acts as a vasodilator.
Can slow renin release

58
Q

What does aldosterone act to do?

A

Increase reabsorption of sodium (water follows) in the kidney - keeps blood volume up - aldosterone keeps up blood pressure

59
Q

Where is atrial natriuretic peptide released from?

A

Atria - in response to stretch by increased blood volume

60
Q

What is Conn’s Syndrome (Primary Aldosteronism)?

A

A condition where excessive aldosterone is produced, raising blood pressure, often treated with surgery or spironolactone.

61
Q

What is Addison’s Disease?

A

A rare disorder causing low cortisol and aldosterone levels, leading to sodium loss, reduced blood volume, and postural hypotension.

62
Q

What are some common causes of hypotension?

A

Dehydration, heart failure, arrhythmias, shock, medication, pregnancy, and orthostatic hypotension.

Week 1 - Hypertension (4 decks)

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