HTN 1

Question 1

HTN Risk Factors

Answer 1

1. age
2. tobacco
3. genetic
4. Low SES
5. obesity
6. sedentary lifestyle
7. psychosocial stress
8. FHx of HTN
9. Excessive alcohol
10. High Na+ diet

Question 2

Sympathetic Nervous System Activity

Answer 2

1. Vasoconstriction
2. Tachycardia
3. Renin Release
4. Vascular remodeling
5. Renal Na+ retention
6. Increased contractility
7. increased Ejection Fraction
8. Increased Peripheral resistance

Question 3

3 situations that lead to renin release

Answer 3

1. Increased Sympathetic tone
2. Decreases Blood Flow to Macula densa
3. # 2 leads to decreased NaCl to macula densa

Question 4

Angiotensin II

Answer 4

Angiotensin II binds to AT1 receptors:

• direct vasoconstriction
• Increased BP
• Cardiac hypertrophy
• smooth muscle proliferation
• aldosterone release

Question 5

Aldosterone

Answer 5

1. Increase Na+/H20 reabsorption
2. Increase ECF volume
3. Renal and vascular remodeling
4. Contributes to endothelial dysfunction
5. Stimulates Inflammatory response

Question 6

Examples of End-organ damage

Answer 6

1. LVH
2. heart failure
3. CKD
4. renal failure
5. aortic dissection
6. retinal abnormalities

Can be due to increased workload on the heart, arterial damage from HTN, accelerated atherosclerosis

Question 7

Lifestyle Modifications

Answer 7

1. Weight reduction (10lbs)***: 5-20 mmHg
2. DASH diet: 8-14 mmHg in 2 weeks
3. Dietary Na+ reduction***: 2-8 mmHg
4. Physical Activity: 4-9 mmHg
5. Moderation of alcohol (men-2, women-1): 2-4 mmHg
6. Smoking cessation: 3.5 mmHg in 1 week

***Most effective-decreases risk of HTN by 20%

Question 8

DASH Diet

Answer 8

1. 8-10 fruits/veggies
2. 2-3 low-fat dairy
3. low Na+, saturated fat, cholesterol
4. fish poultry, whole grains
5. Low in red meat

Question 9

Sodium Intake

Answer 9

Less than 2300 mg/day

Or

Less than 1500 mg/day for those with HTN, obesity, 51 or older, DM