Hypertension Flashcards
What is primary/essential hypertension?
Primary/essential hypertension: Hypertension caused for unknown reasons
Secondary hypertension is?
Secondary hypertension is when hypertension has an identifiable cause.
Which medications are used to treat hypertension?
Medications used to treat hypertension:
- Angiotensin-converting enzyme inhibitors (ACE)
- Calcium channel blockers
- Diuretics
- Angiotensin receptor blockers
- Beta blockers
- Adrenergic blockers (Alpha I)
- Central adrenergic blockers (Alpha II)
- Vasodilators
- Centrally acting agents
- Direct renin inhibitors
- Nitrates
Angiotensin-converting enzyme inhibitors
Mode of action
Names
Side effects
Angiotensin-converting enzyme inhibitors
* Mode of action: Act on renin-angiotensin aldosterone system (RAAS) pathway. Inhibit the conversion of angiotensin I to angiotensin II> lowers systemic BP due to inhibition of vasoconstriction, aldosterone and reduces sodium reabsorption. Reduces work of the heart (reduces preload and after load)
* Names: All end in “pril”: Lisinopril, enalapril, captopril, ramipril, perindopril
* Side effects: Angioedema (induced oedema), renal failure
* Protective against proteinuria
Name two effects of angiotensin II
Two effects of angiotensin II:
* Constricts artetioles
* Increases aldosterone production by the adrenal cortex
* Increases antidiuretic hormone release from the posterior pituitary gland
What is the name of the 280amino acid peptide released by secretory granules in atrial cells due to stretching of walls that acts as an aldosterone antagonist and endogenous diuretic?
Atrial natriuretic peptide is the name of the 280amino acid peptide released by secretory granules in atrial cells due to stretching of walls that acts as an aldosterone antagonist and endogenous diuretic
__________ slows down the rate and force of blood pressure.
Acetylcholine slows down the rate and force of blood pressure.
Where are the main baroreceptors located?
The main baroreceptors are located in the carotid sinus and aortic arch of the cardiovascular system
Summarise the baroreceptor reflex pathway
Baroreceptor reflex pathway:
* Regulates blood pressure
* Baroreceptors= stretch/ pressure sensitive receptors
* Sends information to the brain when blood pressure changes
* BP too high: vasodilation and decreased heart rate occurs
* BP too low: vasoconstriction and increased heart rate occurs
* CV centres in brain regulate sympathetic and parasympathetic response to baroreceptor information received
If blood pressure falls?
If blood pressure falls to increase BP:
* Increased sympathetic activity/decreased parasympathetic activity
* Increased noradrenaline/Acetylcholine
* Constriction of small arteries &arterioles/Activation of B1 heart receptors
* Increased peripheral resistance and cardio output> INCREASE IN BP
If blood pressure is too high?
If blood pressure is high, to decrease BP:
* Decreased sympathetic activity/increased parasympathetic activity
* Decreased noradrenaline (binds to B1)/Acetylcholine
* Relaxation of small arteries &arterioles/Activation of Ach M2 heart receptors
* Decreased peripheral resistance and cardio output> DECREASE IN BP
What is defined as high blood pressure/hypertension?
High blood pressure/hypertension:
* Consistent recording of systolic BP: >/= 140 mm Hg
* Consistent recording of diastolic BP: >/= 90 mm Hg
Primary (essential) hypertension is most common in which population?
Primary (essential) hypertension is most common in African American or people with family history of it
What are the risk factors associated with Primary (essential) hypertension?
Risk factors associated with Primary (essential) :
* Obesity
* Alcohol
* Sodium intake
* Hyperlipidaemia
* Diabetes
* Genetics
* Stress
Which conditions are associated with secondary hypertension?
Conditions associated with secondary hypertension:
* Renal Artery Constriction
* Atherosclerosis
* Phaeochromocytoma (tumour of adrenal glands)
* Cushing’s syndrome (hypercortisolism, too much cortisol)
* Primary aldosteronism (elevated aldosterone)
