HTN/Atherosclerosis Flashcards
Arteriosclerosis
thick, harder less elastic artery
Arteriolosclerosis
Hardening/damage to the small arterioles - usually caused by HTN, DM, advancing age. microvascular disease
Atherosclerosis
Hardening of arteries due to plaque deposits. macrovascular disease
Risk factors of atherosclerosis
HTN, hyperglycemia, high cholesterol (LDL), smoking, advanced age, male, postmenopausal female, fam history, stress, diet
Complications of atherosclerosis
leads to weakened vessel walls
- dissection: separation or tear of layers of the vessel
- aneurysms: ballooon-like bulge
- narrowed arteries lead to reduced bld flow, lead to kidney disease, and kidneys will compensate by activating raas b/c thinks BP is low
- plaque rupture: fibrous cap cracks and exposes foam to blood, leads to clot, risk of embolism
Tx atherosclerosis
prevention
Prevention atherosclerosis
treat co-morbidities (HT, Diabetes), lipid control, lifestyle changes
Complications of vascular disease
chronic illness, acute limb ischemia
Lipid panel
total cholesterol - estimate of all in bld <200
LDL - bad <150
HDL - protects against heart disease >40/50
triglycerides - another type of fat <100
CAD - coronary artery disease
buildup of plaque in arteries that supply bld to the heart
Hyaline vs hyperplastic ateriolosclerosis
hyaline - high pressure blood flow from HTN causes proteins to leak into vessel wall - buildup narrows opening
hyperplastic - thickening of bld vessel walls from HTN (add more layers of muscle to make them stronger –> narrowing)
chronic peripheral arterial disease
I: asymptomatic (may have bruit, decreased pulses)
II: claudication (pain with exercise)
III: pain with rest (usually in toes, foot)
IV: necrosis/gangrene
signs of peripheral arterial disease
weak/absent pulses, temp differences in lower extemities, slow cap refill, bruit, loss of hair on lower calf/ankle/foot, thick toenails, dry/pale/mottled skin, cyanosis
angioplasty
open blocked artery with a balloon followed by placement of a stent
six Ps of ischemia
pain pallor pulselessness paresthesia paralysis poikilothermy (coolness)
Primary HTN
developed over time - from lifestyle, genetics, stress, aging
HTN categories
normal - <120/80 elevated - 120-129/<80 HTN 1 - 130-139 OR 80-89 HTN 2 - 140 or higher OR 90 or higher hypertensive crisis - >180 and/or >120
risks for HTN
Modifiable: diet, obesity, inactivity, smoking, hyperlipidemia, diabetes
Non-modifiable: genetic, family hx, african american, age, male
HTN management (non pharm)
monitor BP, diet (DASH, low salt), exercise, weight loss, alcohol reduction (1-2drinks), stop smoking, reduce stress
HTN management (pharm)
1st line - reduce fluid volume to decrease SV: diuretics
- Inhibit neural side of BP: alpha or beta blockers
- inhibit hormonal side: renin blocker, ACEi, ARB, aldosterone antagonists
- act on vessels directly to prevent vasoconstriction and decrease SVR: calcium channel blockers
TX hypertensive crisis
lower BP slowly
arterial line gives continuous BP
IV antihypertensives
HTN complications
arteriosclerosis, PVD, aneurysms, hypertensive retinopathy, stroke, CKD, CAD
signs of HTN
headache, facial flushing, dizziness, fainting
proper BP technique
take in both arms
2 or more readings each visit
appropriate cuff
stay still, avoid smoking,caffeine or exercise within 30 min before
proper BP technique
take in both arms
2 or more readings each visit
appropriate cuff
stay still, avoid smoking, caffeine or exercise within 30 min before
Signs of hypertensive crisis
headache, SOB, epistaxis, heart palpitations, anxiety, nausea, lightheadedness
DASH diet
fruits and veg, low fat dairy, whole grains, low meat, low sweets
