Hypertension

Question 1

What is the meaning of hypertension?

Answer 1

An increase in blood pressure.

Question 2

What is meant by a pre clinical state?

Answer 2

This is when the problem hasn’t shown itself (vague symptoms).

Question 3

What is the prevalence of hypertension?

Answer 3

Higher in poor lifestyle choices (type 2 diabetes). More likely in Western countries (takeaways and not exercising).
Those who are male, black and older are more likely to be hypertensive.
Hypertension increasing as we have an ageing population (more likely with older people).

Question 4

What is the definition of blood pressure?

Answer 4

This is the pressure exerted against the walls of the blood vessels (arteries).

Question 5

What are the different types of blood pressure?

Answer 5

-systolic (LV contracting)
-diastolic (LV relaxing)

Question 6

How is blood pressure calculated?

Answer 6

systolic/diastolic

Question 7

What are the units for blood pressure?

Answer 7

mmHg.

Question 8

What impact does the nervous system have on blood pressure?

Answer 8

Involves fight or flight causing heart rate to increase, generate tone (vasodilation, vasoconstriction).

Question 9

What impact does the humoral system have on blood pressure?

Answer 9

To do with kidneys, blood volume, slower to have an effect.

Question 10

What is the RAAS system?

Answer 10

The renin angiotestin aldosterone system.

Question 11

What is the process of the RAAS system?

Answer 11

When there is low blood flow o the kidneys, renin is released which converts angiotensinogen to angiotensin 1 which is put into circulation. In the lungs, angiotensin 1 converted to angiotensin 2- is powerful vasoconstrictor.
Aldosterone is a Na and water retention which increases pressure and reduce amount of renin produced.

Question 12

What is the meaning of ectopic?

Answer 12

Extra beats

Question 13

What causes the heart to beat faster?

Answer 13

If the right atrium that is receiving blood is stretched (more blood)- beats faster.

Question 14

How is blood pressure a negative feedback system?

Answer 14

When there is a detection of higher pressure, it is stretched and this sends a signal to the CV system as it is trying the reverse the direction of change (carotid bodies).

Question 15

What are the types of hypertension?

Answer 15

-Primary/ essential
-Secondary
-Whitecoat
-Malignant
-Masked

Question 16

What is meant by primary/ essential hypertension?

Answer 16

This has no known cause, can be genetic, lifestyle choice, stressful job etc. A low birth weight is associated with hypertension as they grow up (due to smoking or drinking of the mother).

Question 17

What is meant by secondary hypertension?

Answer 17

This is caused by some sort of pathology such as weight, diet etc. If you secrete a lot of adrenaline or noradrenaline, it causes vasoconstriction so increases blood pressure. There are clues if it is this type as people are often younger.

Question 18

What is meant by whitecoat hypertension?

Answer 18

This is classed as a ‘false’ high reading as the patient may be nervous or uncomfortable in a hospital (would drop to normal when they leave). They would be monitored annually to ensure it is still whitecoat.

Question 19

What is meant by malignant hypertension?

Answer 19

This is where the BP is above 120 diastolic. It can cause kidney and eye damage- leads to a high medical emergency.

Question 20

What is meant by masked hypertension?

Answer 20

This is the opposite of whitecoat (the BP is lower than expected when measured).

Question 21

What is normal during sleep regarding blood pressure?

Answer 21

A nocturnal dip.

Question 22

What is the equation for blood pressure?

Answer 22

Blood pressure= Cardiac output x Peripheral Resistance

Question 23

What is the value for a hypertensive blood pressure?

Answer 23

140/90

Question 24

What is end organ damage?

Answer 24

Hypertension can have detrimental effects on organs. In the heart, causes hypertrophy- walls of the heart getting bigger and thicker. The left ventricle wall is very thick and the chamber is tiny leading to a higher demand of blood (more myocardium).
Also cause stroke, renal failure (kidneys), damage to retina which left untreated can damage sight.

Question 25

What is the meaning of an increased afterload?

Answer 25

The aortic pressure is increased (the LV has to work harder if aortic pressure is higher as it has to overcome this).

Question 26

What is diastolic dysfunction?

Answer 26

This is when you can’t relax properly (higher muscle mass).

Question 27

What is accelerated atherosclerosis?

Answer 27

This is the build up of plaque inside the vessels meaning they narrow (leads to CHD).

Question 28

What are the lifestyle treatments for hypertension?

Answer 28

These are things people can do themselves: decreasing number of cigarettes (decrease damage to walls of arteries), weight (lower BP if lose weight), exercise, diet, alcohol.

Question 29

What are the pharmaceutical treatments for hypertension?

Answer 29

-Diuretics (make people urinate which decreases the amount of blood circulating)
-Beta blockers (lower heart rate, stops effects of adrenaline and noradrenaline, force of contractility decreases)
-Calcium channel blockers (stopping contraction of smooth muscle in arteries)
-ACE inhibitors (stop angiotensin 1 being converted to angiotensin 2- stops vasoconstriction)