HTN and HF Flashcards
What is hypertension?
- A sustained elevation of BP.
- A sign that the heart and blood vessels are being overworked.
What is a normal BP?
Systolic: less than 120
Diastolic: less than 80
What will be the result if high blood pressure is untreated?
- Atherosclerosis
- Congestive Heart Failure
- Organ damage
- Cardiomyopathy
How is BP determined?
- Cardiac Output (stroke volume x heart rate)
- Peripheral Resistance
What are the regulatory mechanisms for BP?
- Arterial baroreceptors
- Renal regulation of body fluid volume
- Renin-angiotensin-aldosterone system
What is the function of arterial baroreceptors?
Monitor the level of arterial pressure in:
- Carotid sinus
- Aortic arch
- Left ventricle
The arterial baroreceptors found in the aorta & left ventricle monitor the level of arterial pressure & vasodilation.
How does the renal system regulate the body fluid volume?
Excess salt & water changes venous return to the heart causing rise in CO (Cardiac Output), especially if the pt has poor kidney function
What is the function of renin, angiotensin, and angiotensin II?
They are vasoconstrictors that inhibit release of salt excretion from the kidneys.
Name the modifiable risk factors for HTN:
- Tobacco use
- Dyslipidemia (LDL)
- Excess dietary sodium (decrease intake)
- Obesity (lose at least 5lbs)
- Sedentary lifestyle
- Alcohol use
- High caffeine intake (stimulant; boost HTN)
- Stress
Name the non-modifiable risk factors for HTN:
- Age: 50% of ppl over 60 have HTN
- Ethnicity: 2x more prevalent in AA’s
- Gender: Men under 55 yrs; Women over 55 yrs
- Family history
- Socio-economic status
What is HTN also known as?
The silent killer
What are the two major classifications of HTN?
- Essential or Primary (idiopathic) Hypertension
- Secondary Hypertension
How does Essential or Primary (idiopathic) HTN begin?
- It has no known cause
- Begins as a benign disease and progresses
What are the associated risk factors with Essential or Primary (idiopathic) HTN?
- Family history, age, race
- High sodium intake
- Physical inactivity
- Excessive alcohol intake / smoking / drugs
- Low potassium, calcium, magnesium intake
- Excessive calorie consumption, obesity
How does secondary HTN begin?
It’s related to a specific disease
What specific diseases can cause secondary HTN?
- Renal disease
- Coronary artery disease
- Dysfunction of adrenal glands
- Neurogenic disease; brain tumors, encephalitis
- Pregnancy
- Medications: estrogens + oral contraceptives
- Psychiatric disorders
What is benign primary hypertension?
- Usually has no symptoms
- Has an elevated BP (140-150/90-99)
- Early signs: palpations + headache
What is resistant hypertension?
High BP that is under control, but requires for or more meds that are also considered resistant.
How does resistant hypertension occur?
- Occurs if the pt’s BP remains above goal
- BP still resistant when taking 3 meds from different antihypertensive categories.
What is accelerated hypertension?
When the BP has increased over a short period of time
What are the symptomatic vascular changes associated with accelerated hypertension?
- Heart attack
- Epistaxis
- Hematuria
- Proteinuria
- Angina
What is malignant hypertension?
- Rapid, progressive severe vascular changes
- BP readings of SBP > 200 mmHg, DBP > 150 mmHg
- Needs RAPID intervention
What symptoms are associated with malignant hypertension?
- Morning headaches
- blurred vision
- dyspnea
- uremia
What progressive systemic complications are associated with malignant hypertension?
- Renal failure
- L. Ventricular failure
- End-stage renal disease
- CVA (cerebrovascular accident aka stroke)
- MI (myocardial infarction aka heart attack)
