HTN heart disease Flashcards
what is the double product?
HR x Systolic BP
estimate of how hard the heart works
what blood pressure is considered normal?
systolic less than 120
AND
diastolic less than 80
what BP is considered elevated?
systolic 120-129
AND
diastolic less than 80
what BP is considered high (hypertensive stage 1)?
systolic 130-139
OR
diastolic 80-89
what BP is considered hypertensive stage 2?
systolic 140 or higher
OR
diastolic 90 or higher
what BP is considered to be a hypertensive crisis?
systolic higher than 180
AND/OR
diastolic higher than 120
list several drug types used in the pharmacologic management of HTN heart disease
- Diuretics
- Beta blockers
- Calcium channel blockers
- angiotensin converting enzyme inhibitor (ACE)
- Alpha 1 blockers
- Central agents
- Aldosterone receptor blocker
T/F: pts are relatively consistent with taking their antiHTN meds
FALSE
only 20% of pt seeking care for HTN take all of their meds
why do pts stop taking their anti HTN meds?
- unpleasant side effects
- interference with sexual function
- cost
- taking anti-HTN does not change the way a pt feels so why take them?
- increased age
- gender → women exhibit greater non-adherence
- African Americans greater risk for non-adherence
what are the types of HTN?
essential (primary) HTN
secondary HTN
describe essential (primary) HTN
idiopathic
90% of all cases
describe secondary HTN
caused by conditions that affect your kidneys, arteries, heart or endocrine system
10% of all HTN cases
trx focuses on management of the underlying cause
T/F: uncontrolled HTN can lead to kidney disease
TRUE
uncontrolled HTN result in thickened capillaries in the glomerulus which impedes the movement of fluids and molecules out of the blood and into the kidney tubules
what is the net effect of HTN on the kidneys?
increased preload
increased total peripheral resistance
decreased ability to appropriately control whole body BP
creates a downward spiral in kidney function
how does HTN result in pathologic changes in the heart?
- results in pathologic cardiac hypertophy
- causes fibrosis rendering the heart stiffer
- HFpEF
- myocyte hypertrophy
- accelerated myocyte death
- reduced capillarization/reduced blood flow
- hypetensive heart is an ischemic organ
what are the s/s of malignant HTN?
- changes in vision including blurred vision
- chest pain
- cough
- anxiety
- SOB
- HA
- numbness or weakenss in the arms, legs, or face
- N/V
what is cor pulmonale?
also called pulmonary heart disease
enlargement/dysfunction of the RV caused by a primary pulmonary disorder (pulmonary HTN)
T/F: the pulmonary side of circulation is low pressure system
TRUE
why can the R side of the heart move the same volume of blood as the L side of the heart?
RV has the same SV as LV
shorter length of tubing
more compliant vessels
much lower impact on gravity on blood flow
what are the symptoms of cor pulmonale?
- chest pain
- fatigue
- bilateral LE edema
- syncope or passing out
list some lung diseases that associated with cor pulmonale
- COPD
- diffuse pulmonary interstitial fibrosis
- extensive, persistent atelectasis (collapsed lung)
- cystic fibrosis
- pulmonary embolism
list some diseases of the pulmonary vessels associated with cor pulmonale
- pulmonary vascular stenosis
- drug, toxin, XTR induced vascular sclerosis
list some disorder affecting chest wall movement associated with cor pulmonale
- kyphoscolosis
- marked obesity (Pickwickian syndrome)
- neuromuscular disease
list diseases inducing pulmonary arteriolar constriction associated with cor pulmonale
- hypoxemia (low levels of O2 in blood)
- COVID 19 does this
- airway obstruction
- hypoventilation
- chronic altitude sickness
what is the relationship between exercise and pulmonary arterial HTN?
- care should be taken not to over exercise
- light resistance of small muscle groups and light to moderate aerobic activity is acceptable
- outdoor activity should be avoided during hot or humid weather or very cold weather
- encourage pt to speak with physcian
