Hypertension

Question 1

What is hypertension defined as

Answer 1

-B/P> or = to 140-90
-‘pre hypertension’ is defined as 130-139/85-89 (high normal)

Question 2

How many Canadians have hypertension

Answer 2

19% of adults 20-79 years old have hypertension (increases with age)

Question 3

What’s arterial BP

Answer 3

Arterial BP = Cardiac output x systemic vascular resistance (SVR)

Question 4

Primary hypertension

Answer 4

-Unknown cause
-Accounts for 90-95% of all hypertension
-Cause unknown

Question 5

Secondary hypertension

Answer 5

-Cause can be identified (I.e. renal disease, brain tumours, head injury, cocoaine, sleep apnea, casings disease)
-Accounts for 5-10% of cases

Question 6

Risk Factors

Answer 6

-Age
-Heavy alcohol consumption
-Cigarette smoking
-Diabetes Mellitus
-Elevated serum lipids
-High dietary sodium intake
-Gender
-Family history
-Obesity
-Ethnicity
-Sedentary lifestyle
-Socioeconomic status
-Psychological status

Question 7

Signs and symptoms

Answer 7

-largely silent, the silent killler
-Usually asymptomatic
-Can have
•fatigue
•reduced activity tolerance
•dizziness
•palpaitons
•angina

Question 8

What are the complications of hypertension

Answer 8

-Heart
-Brain
-Kidney disease
-Eyes

Question 9

Hypertension; Collaborative care

Answer 9

-BP monitoring
-Bloodwork
-Restrict Sodium
-Reduce weight
-Restrict cholesterol and fats
-Adequate K, Ca and magnesium
-Regular moderate activity
-Stop smoking
-Moderate alcohol
-Antihypertensive drugs

Question 10

Thiazide and related diuretics (I.e. chlorthalidone hydrochlorothiazide)

Answer 10

-Inhibits NaCl reabsorption in distal convoluted tubule
-Increases the NaCl excretion, therefore decreases SVR (2-4wks to impact B/P)

Question 11

Loop Diuretics (I.e. furosemide)

Answer 11

-Inhibits NaCl reabsorption in loop of henle
-More potent than thiazides, but shorter duration

Question 12

Potassium soaring diuretics (I.e. spironolactone)

Answer 12

-Inhibits Na retaining and K excreting effects aldosterone in the distal and collecting tubes

Question 13

Central-Acting Adregenic Antagonists (I.e. catapres)

Answer 13

-Reduce sympathetic outflow from CNS
-Reduce peripheral sympathetic tone-vasodilates: lower SVR and BP

Question 14

Beta-adrenergic blockers (I.e. atenolol, metropolol)

Answer 14

-Reduce BP via beta 1 antagonist activity
-Reduce sympathetic vasoconstrictor tone
-Decrease kidney renin production

Question 15

?-Adrenergic blockers (I.e. minipres)

Answer 15

-Cause peripheral vasodilation this causing lower BP and SVR