HTN1

Question 1

what are the two classification groups of HTN? what percent of HTN is each

Answer 1

essential HTN =90%

secondary HTN = 10%

Question 2

what is the basic formula of BP?

Answer 2

BP= CO x SVR

CO - cardiac output
SVR = systemic vascular resistance

Question 3

what is cardiac output

Answer 3

volume pumped by a ventricle per minute

bpm x stroke volume

Question 4

what is the maximum bp during cardiac contraction

Answer 4

systolic blood pressure

Question 5

what is the major determinant of systemic vascular resistance

Answer 5

diastolic blood pressure

Question 6

what is the minimal bp during heart chamber filling?

Answer 6

diastolic blood pressure

Question 7

what occurs with aging where aorta becomes stiff and cant open up as much when heart contracts

Answer 7

isolated systolic hypertension

Question 8

how is pulse pressure calculated

Answer 8

systolic - diastolic - pulse pressure

Question 9

what is the average normal pulse pressure

Answer 9

120-80= 40

Question 10

what two systems are targeted in treating the pathophysiology of HTN

Answer 10

Renin- Angiotensin Aldosterone System
Neuronal Mechanisms (alpha and beta receptors)

Question 11

what stimulates the kidneys to release renin?

Answer 11

renal hypoperfusion

Question 12

angiotensin II has what two major effects

Answer 12

1. direct vasoconstriction and increase in volume

2. release of aldosterone

Question 13

what are the two presynaptic neuronal mechanism and there effect?

Answer 13

1. presynaptic alpha stimulation decreases NE release

2. presynaptic beta stimulation increases NE release

Question 14

what are the effects of postsynaptic alpha receptor stimulation?

Answer 14

vasoconstriction

Question 15

what are the effects of each postsynaptic beta receptor being stimulated?

Answer 15

B1 (heart = increase heart rate and contractility

B2 (lungs) = vasodialtion

Question 16

beta blockers in what patients may be potentially harmful?

Answer 16

asthma patients

Question 17

what are some risks of HTN?

Answer 17

1. atherosclerosis of veins

2. left verntricular hypertrophy (working harder)

Question 18

what is caused by left ventricular hypertrophy?

Answer 18

1. increased afterload
2. arterial damage
3. increase risk of heart failure

Question 19

for every 20 mmHg increase in systolic BP how much is the risk of CV disease increased?

Answer 19

doubles risk of CV disease

Question 20

for every 10 mmHg increase in diastolic BP how much is the risk of CV disease increased?

Answer 20

doubles risk of CV disease

Question 21

what are 3 major benefits of antihypertensive therapy?

Answer 21

1. decrease risk of stroke by 30-45%
2. decrease MI by 20-25%
3. decrease HF by 50%

Question 22

if a patient has HTN and once other CV risk factor what amount of decrease in BP over 10 years prevents 1 death out of 11 treated?

Answer 22

12mmHg decrese

Question 23

why is HTN considered a silent killer?

Answer 23

it is asymptomatic;

don’t see or feel any changes

Question 24

what are some factors needed for proper BP measure

Answer 24

1. no exercise, smoking or caffeine for 30 min. prior
2. 5 minutes of rest before taking bp
3. feet flat on floor and arms at proper level
4. cuff properly sized
5. readings at least 5 minutes apart and take avg.

Question 25

what are the new guidelines for managing HTN

Answer 25

Joint National Commision 8 (JNC8)

Question 26

how many recommendations are there for management of HTN in JNC8

Answer 26

9 primary recommendations

Question 27

what are 3 significant changes seen in JNC8

Answer 27

systematic review limited to RCT evidence
similar treatment goals for all HTN population
addresses limited number of high priority questions