heart problems Flashcards
what are modifiable factors that will limit hypertension?
- smoking
- type 2 diabetes
- obesity
- diet
- physical activity
- alcohol
(Brooker et al, 2013)
what are non modifiable factors that cannot be changed and may cause hypertension?
- age
- sex
- ethnicity
- genetics
(Brooker et al, 2013)
what is hypertension?
- raised arterial blood pressure and determined by cardiac output and the total peripheral resistance of the circulatory system
(Brooker et al, 2013)
what can hypertension cause?
- stroke
- myocardial infarction
- kidney dysfunction
(Brooker et al, 2013)
what is the average BP for someone with hypertension?
should be below 130/80
(Brooker et al, 2013)
why should people have a lower BP?
- lower pressure associated with lower risk
- cardiovascular risk increases linearly from 115/70 to 170/100
- lowering BP can lead to relative reduction in risk of around 22% for ischemic heart disease and around 41% for stroke
(Brooker et al, 2013)
what BPs would people have if they were stage 1, 2 and 3 hypertensive?
1 = systolic - 140-159
diastolic - 90-99
2 = systolic - 160- 179
diastolic - 100-109
3= systolic - >180
diastolic - >110
(Hussain and Prerana, 2018)
what is mean arterial pressure (MAP)?
- cardiac output X peripheral resistance
- altering either of these will have an effect on the blood pressure
(Brooker et al, 2013)
how is the cardiac output measured?
- heart rate X stroke volume
- expressed as the volume of blood pumped by the heart in one minute
(Brooker et al, 2013)
how do you work out the end systolic and end diastolic volume?
end diastolic = how much the heart fills
end systolic = how much the heart empties
(Brooker et al, 2013)
how does filling of blood into heart happen?
- determined by return of blood from venous system, and emptying the heart by the contractility of the heart muscle
- increase in blood volume can result in an increased cardiac output
(Brooker et al, 2013)
what total peripheral resistance (TPR)?
sum of resistance offered by the small arteries and arterials to the flow of blood
(Brooker et al, 2013)
what is Poiseuille’s law?
- resistance to flow in any blood vessel will be related to viscosity of blood
(Brooker et al, 2013)
why is the radius of the vessel important?
- The length of vessels and blood viscosity tend to not change so the most important factor is the radius of the vessel itself
- Small changes in radius will lead to large changes in peripheral resistance and potentially blood pressure
(Brooker et al, 2013)
how is blood pressure regulation achieved?
- through autonomic nervous system and hormonal mechanisms
- immediate control is control managed by Baroreceptors reflexes
(Brooker et al, 2013)
how is increased BP detected?
- sensory endings in carotid sinuses and aortic arch
- results in a decrease in sympathetic stimulation of the heart reducing heart rate, reducing BP
(Brooker et al, 2013)
what are complications of hypertension on the heart?
- left ventricular hypertrophy can lead to diastolic heart failure
- cardiac arrhythmias
- myocardial infarction
- sudden death
(Brooker et al, 2013)
what are complications of hypertension on the brain?
- ischaemic or hemorrhagic stroke
- associated with impaired cognition in elderly
(Brooker et al, 2013)
what are complications of hypertension on the kidneys?
- major factor in development of renal disease and accelerating progression of other underlying renal disease
(Brooker et al, 2013)
what are complications of hypertension on peripheral arteries?
- blood vessels are common site of hypertension related complications
- atherosclerosis is underlying issue in development of peripheral vascular disease leading to a narrowing of the vessel, and pain where there is insufficient perfusion of tissues
(Brooker et al, 2013)
what are lifestyle changes that can help combat hypertension?
- more exercise
- balanced diet
- no smoking
- no alcohol
- reduce sodium intake
- maintain calcium, magnesium, sodium intake
(Brooker et al, 2013)
what medications can be taken for hypertension?
- diuretics (furosemide)
- calcium channel blockers (amlodipine)
- ACE inhibitors (ramipril)
- Beta blockers (propanolol, atenolol)
(Brooker et al, 2013)
what is ischemic heart disease?
- lack of blood and demand for the heart muscle
- coronary arteries are unable to supply sufficient oxygen to the heart muscle for it to function
(Brooker et al, 2013)
what can ischemia look like?
- can be minor and reversible: angina pectoris causing pain and discomfort upon exertion
- can be major irreversible event resulting in cell death of the heart muscle and possible death of individual, this is myocardial infarction
(Brooker et al, 2013)