Hypertension Flashcards
In what capacity is venous blood related to blood pressure?
It is a capacity pool that is holding blood volume
What happens to vasculature as we age?
becomes stiffer
With stiffer vessels, what happens to relative systolic and diastolic pressures?
systolic gets higher, diastolic stays the same or goes lower
Names of sounds heard at different phases when measuring NIBP?
Karatkoff
Basic process of NIBP measurement?
Cuff inflated to occlude artery. Cuff deflated and oscillations measured to determine systolic, diastolic pressure.
Describe what MAP measures
Measure of entire blood ejected during entire systolic, diastolic period
Describe pulse pressure
difference between systolic and diastolic pressures
Why is persistent high BP bad for the heart? (very basic)
It is increased resistance that the heart has to beat against
How is high blood pressure bad for the arterial system?
Increased resistance in arterial system distends arteries, causing SHEERING FORCES, damaging endothelium and muscular layer of vessels, leading to accelerated athlerosclorosis
Stage 1 hypertension is AKA
Early HTN
Pressures for early HTN
140/90 +
What is hypertensive crisis?
BP’s >180 +- / >110
What is hypertensive emergency?
Hypertension + end organ dysfunction (i.e. vessel rupture)
Why might we not want to drop the BP too much with hypertensive emergency?
May lead to poor perfusion in ruptured area
What categories of HTN are there?
essential, chemical, renal-vascular
Examples of causes of chemical HTN?
Causes of electrolyte retension, leading to increase in IV volume, changes in vascular reactivity. Causes - Cushing’s diseas, Addison’s disease, problems with Na metabolism/excretion, CNS or ANS dysfunction
Causes of renal-vascular HTN?
Anything that effects feedback regulation at kidneys. Anything that causes lack of perfusion, stenosis (narrowing of renal artery). Pheochromocytoma.
Increase in BP and HR in normal pt due to surgical stimulation?
BP increase 20-30mmHg, HR increase 15-20 bpm
Increase in BP and HR in hypertensive pt due to surgical stimulation?
BP increases up to 90mmHg, HR increases up to 40 bpm
Explain BP autoregulation in basic terms
Organs vasodilate or vasoconstrict inflow vessels in order to provide adequate perfusion or prevent excessive flow
What is range of BP to keep pt in?
+- 20% of normal
Why keep BP +- 20% in hypertensive pt?
Autoregulation has developed over time to protect organs at high blood pressure. Dropping BP too much could decrease perfusion to organs by dangerous amount.
Patients with HTN are how much more likely to die from CV complications than pts w/out?
40%
How is the baroreceptor response in hypertensive patients to changes in BP?
it’s blunted
hypercarbia hypoxia and agitation can impact sympathetic output and vascular tone
indeed
bladder distension can lead to…?
hypertension
diastolic of what may be criteria for cancelling a case
110
