Hypertension

Question 1

What is blood pressure determined by?

Answer 1

Cardiac output and systemic vascular resistance

Question 2

What is cardiac output determined by?

Answer 2

Stroke volume and heart rate (SV x HR)

Question 3

How does the sympathetic nervous system affect blood pressure?

Answer 3

Baroreceptors sense BP changes and signal the vasomotor centre in the brain to change cardiac output and systemic vascular resistance

Question 4

How does the endocrine system affect blood pressure?

Answer 4

Drops in BP stimulate the sympathetic nervous system, triggering vasoconstriction, increased cardiac output and triggering renin release from the kidneys to promote the Renin-Angiotensin-Aldosterone System

Question 5

What is hypertension?

Answer 5

Persistent or ongoing high blood pressure readings (>140mmHg systolic or >90mmHg diastolic)

Question 6

What happens to the circulatory system during hypertension?

Answer 6

The high pressure causes endothelial damage

The heart works harder than normal, putting the heart under more stress

Baroreceptors adjust to the new “normal” pressure

Question 7

What are the potential complications of the endothelial damage associated with hypertension?

What are the signs and symptoms?

Answer 7

Stroke
Blindness
Heart attack and heart failure
Atherosclerosis
Kidney failure

Symptoms:
None until organ failure

Question 8

What is a hypertensive emergency?

What are the signs and symptoms of a hypertensive emergency?

Answer 8

A sudden increase of BP (either systolic or diastolic) with evidence of acute organ damage

Symptoms:
- Severe headache
- Chest pain
- Shortness of breath
- Blurred vision
- Confusion
- Seizure
- Nausea and vomiting

Question 9

What are the risk factors for hypertension?

Answer 9

Non-modifiable
- Sex
- Age
- Genetic predisposition
- Diabetes*

Modifiable
- Obesity
- Alcohol
- Smoking
- Caffeine
- Excessive sodium intake
- Lack of physical activity
- Diabetes*

Question 10

What are the main actions of blood pressure medications?

What are the main types of blood pressure medications?

Answer 10

Two main actions:
- Decrease the volume of circulating blood
- Reduce systemic vascular resistance

Types of blood pressure medications:
- ACE-Inhibitors (Reduces production of angiotensin 2)
- Angiotensin Receptor Blockers (Blocks actions of angiotensin 2)
- Beta Blockers (Reduces heart rate & myocardial contractility)
- Calcium channel blockers (Dilates blood vessels)