HTN

Question 1

Hypertension

Answer 1

When blood pressure or the force of blood pushing against the walls of your blood vessels is consistently too high

Genetic and environmental factors

Question 2

Factors that create HTN

Answer 2

Blood volume
Peripheral resistance
Cardiac output

Question 3

Blood Volume

Answer 3

Total amount of blood in the vascular system
Vol can change from disease, drugs, and regulatory factors
Inc blood vol = inc blood pressure

Question 4

Peripheral resistance

Answer 4

Blood traveling around the vasculature at a high rate of speed comes in contact with the smooth endothelium of the vessels, where friction slows it down

Constrict blood vessels = inc blood pressure

Question 5

Cardiac Output

Answer 5

The volume of blood pumped in a ventricle per minute

HR x SV = CO

Inc CO = inc blood pressure

Question 6

4 things RAAS system does?

Answer 6

1) vasoconstriction of blood vessels
2) releases epi, norepinephrine, and aldosterone
3)
4)

Question 7

Primary HTN

Answer 7

No identifiable cause
90% of HTN

Question 8

Secondary HTN

Answer 8

A specific cause can be identified

Ex: Cushings disease, chronic kidney disease, hyperthyroidism, drugs

Question 9

Normal BP range and treatment

Answer 9

<120/<80

None

Question 10

Elevated BP range and treatment

Answer 10

120-129/ <80

Lifestyle changes

Question 11

HTN stage 1 BP range and treatment

Answer 11

130-139/80-89

Lifestyle changes and 1 medication

Question 12

HTN stage 2 BP range and treatment

Answer 12

> 140 / >90

Lifestyle changes and 2 medications

Question 13

Classes of meds to treat HTN (there’s 5)

Answer 13

Diuretics
ACE inhibitors
ARBs
Beta Blockers
Calcium Channels

Question 14

Diuretics

Answer 14

Work by reducing blood volume

• potassium wasting (excrete K+)
  - thiazide
  - loop
• potassium sparing (hang on to K+)

Question 15

Thiazide Diuretics

Answer 15

Old drug
Inexpensive
Can cause hypokalemia

Question 16

Loop diuretics

Answer 16

Causes more peeing than thiazide or potassium sparing drugs
Many adverse effects like hypokalemia and dehydration
Ototoxic
Used for intermittent fluid off-loading

Question 17

Potassium Sparing

Answer 17

Produce only modest diuretics
Hyperkalemia
Can lead to cardiac conduction abnormalities
Don’t use with ACE or ARBs

Question 18

ACE inhibitors

Answer 18

“Pril”
These drugs work with the RAAS system
decrease BP and increase urine vol
Blocks conversion of Ang I to Ang II
Can cause mild cough, postural hypotension, and hyperkalemia
Effect: angioedema

Question 19

ARBs

Answer 19

“Sartan”
Block Ang II receptors in the SM
Relatively few side effects
No cough and much lower list for angioedema

Question 20

Beta Blockers

Answer 20

“Olol”
Block adrenergic receptors
Blockade of B1 receptors in the heart
Dec HR and contractility which Dec CO and BP
Effect: predictable; slow HR and bronchconstriction

Question 21

Calcium channel Blocker

Answer 21

Block calcium ion channels, which block muscle contraction relaxing the smooth muscle and lowers peripheral resistance
Used with other drugs
Biggest side effect is dizziness, peripheral edema, heartburn, nausea, and flushing
Can inc the effect of statin drugs by messing with the liver

Question 22

Hypertensive crisis

Answer 22

BP is > 180/120
Causes organ damage
Due to poorly managed essential HTN
Don’t want to drop BP too fast… could cause orthostatic hypotension