HTN-Clinical Overview Flashcards
What is the eqn for BP (aka AP)?
CO x TPR or
(SV x HR) x TPR
What things determine SV?
preload
contractility
What things determine HR?
ANS
conduction system
What things determine TPR?
- Neurohumoral factors
- local auto regulation (pH, hypoxia, etc.)
What is a normal BP?
less than 120 over 80 based on the least risk of CV complications from studies
What is preHTN?
120-139
80-89
What is stage 1 HTN?
140-159
90-99
What is stage 2 HTN?
160+
100+
JNC 8 HTN treatment goals?
initiate over 150/90 for 60+ and 140/90 for those with chronic kidney disease or diabetes
What things could increase preload (and thus SV and thus CO and thus AP)?
increased fluid volume or venous constriction
What things could increase contractility (and thus SV and thus CO and thus AP)?
sympathetic activity stimulation
T or F. Most patients with uncomplicated HTN have a normal CO
T.
What are some behavioral/dietary causes of essential HTN?
- increased salt intake
- alcohol
- obesity
- sleep apnea
HTN is a major risk factor for what diseases?
- CV disease
- stroke
- end-stage renal disease
- ischemic heart disease
Goals of evaluating hypertensive patients.
1) Obtain an accurate assessment of BP
2) Assess the significance of the BP
3) What is the cause?
Which leads to more inaccurate BP readings, a large cuff on a small arm circumference or a small cuff on a larger arm circumference?
a small cuff on a larger arm circumference will overestimate BP much more than a a large cuff on a small arm circumference will underestimate it
T or F. Caffeine and tobacco should be avoided for 30+ minutes before a BP reading
T.
What things may elevate BP acutely?
- nervousness, stress, anxiety
- drugs (cocaine), alcohol, caffeine, nicotine
- pain
- white coats
How do you assess the significance of the BP?
by stratifying CV risk and looking for target organ damage
For the most part, headaches are not directly related to HTN in a person who chronically suffers from it.
For the most part, headaches are not directly related to HTN in a person who chronically suffers from it.
What are some problems in the vasculature caused by HTN?
atherosclerosis
aneurysm
aortic dissections
What are some problems in the kidneys caused by HTN?
hematuria
proteinema
What are some problems in the heart caused by HTN?
- pulmonary edema
- MI
- left ventricular hypertrophy
What are some problems in the brain caused by HTN?
- Hemorrhage/infarction
- seizures
- vascular dementia