High/Low BP Flashcards
What is normal BP?
120/80
Define hypertension
Defined as a sustained elevation of systemic arterial BP and in the USA 1 in 3 adults diagnosed with it
What is prehypertension BP values?
120-129 systolic
80-89 diastolic
What is Stage 1 Hypertension BP values?
140-159 systolic
90-99 diastolic
What is Stage 2 Hypertension BP values?
160+ systolic
100+ diastolic
What is hypertension caused by?
Increase in CO, TPR, or both
Individuals with hypertensive disease may have either?
Combined systolic and diastolic hypertension OR
Isolated systolic hypertension
Most cases of combined systolic and diastolic hypertension have no known cause and are therefore diagnosed as?
Primary hypertension (idiopathic)
What percentage of hypertension is made up by secondary hypertension?
5 - 8% of all cases of hypertension is made up by secondary hypertension which can result from many diseases
What is isolated systolic hypertension?
This is elevated systolic BP PLUS normal diastolic BP below 90mmHg… so only the systolic BP value is elevated
What does high BP increase with regards to the heart, and relate this to ventricle pressure…..
High BP increases the workload of the heart. So when ventricles contract normally they force open the semilunar valves by generating higher pressure than in the major arteries. In hypertensive patients this means that the ventricles may have to generate up to 400mmHg for force to push the blood through a narrowed aortic valve. (Bad)
What is the role of hypertrophy with regards to after-load?
The heart may be able to compensate for an increase in after-load by enlarging (hypertrophy) which allows it to contract more forceful and maintain a normal SV despite an abnormal impediment to blood ejection
What are 10 factors associated with primary hypertension?
- Family history of
- Advancing age
- Gender - men younger than 55 and women older than 74
- Black race
- High dietary sodium intake
- Glucose intolerance
- Cigarette smoking (nicotine is a vasoconstriction agent)
- Obesity
- heavy alcohol consumption (greater than 3 a day. Moderate drinking of 2-4 per week shows lower BP than abstainers or alcoholoics)
- Low dietary intake of magnesium, calcium, and potassium
What does sodium, calcium, potassium, and magnesium have to do with hypertension?
High dietary sodium intake has long been linked to increased chance of hypertension, however, it is also shown that low levels of calcium, potassium, and magnesium are bad as without their intake sodium is retained
Is nicotine a vasoconstrictor?
Yes - nicotine is a vasconstrictor and this can elevate both systolic and diastolic BP acutely
What does obesity contribute to?
Obesity is recognized as an important risk factor for hypertension and contributes to many of the neurohumoral, metabolic, renal, and CV processes that cause hypertension, especially those factors that contribute to endothelial dysfunction and renal sodium retention
What does inflammation, endothelial dysfunction, and insulin resistance contribute to regarding blood volume and peripheral resistance?
These factors contribute to increases in peripheral resistance and blood volume
What regulates the affects of obesity?
Multiple pathophysiologic mechanisms mediate these affects including the SNS, the RAA system, adducin, and natriuretic peptides
In hypertensive pts. what can cause over activity of the SNS?
Increased production of catecholamines (epi and norepi) or from increased receptor reactivity involving these neurotransmitters
What component of the RAA system is known to contribute to hypertrophy?
Angiotensin II is responsible for hypertrophy of the myocardium associated with hypertension
Drugs that block ______ or ______ and _____ receptors are widely used in the treatment of hypertension and have been shown to improve ______ and _____ _____ in select populations
angiotensin converting enzyme (ACE inhibitors) angiotensin aldosterone cardiac renal function
What % of increase in risk for essential hypertension does a mutation in the gene for the protein adducin cause?
50 - 70% increase
What does natriuretic hormone modulate?
Natriuretic hormone modulates renal sodium excretion and includes ANP (atrial natriuretic peptide), BNP (brain natriuretic peptide), CNP (C-type natriuretic petpite, and urodilanton
What are the functions of natriuretic hormones be affected by?
Excessive sodium intake
Inadequate dietary potassium, calcium, and magnesium intake
Obesity
