Hypertension

Question 1

What constitutes hypertension in terms of blood pressure readings?

Answer 1

A sustained diastolic pressure greater than 90 mm Hg or a sustained systolic pressure in excess of 140 mm Hg constitutes hypertension.

Question 2

Which is more important in determining cardiovascular risk: systolic or diastolic blood pressure?

Answer 2

Systolic blood pressure is more important than diastolic blood pressure in determining cardiovascular risk.

Question 3

List some guidelines in ensuring accurate blood pressure measurement.

Answer 3

🩺 The equipment should be regularly inspected and validated.
🩺 The operator should be trained and regularly retrained.
🩺 The patient must be properly prepared and positioned and seated quietly for at least 5 minutes in a chair.
🩺 The auscultatory method should be used.
🩺 Caffeine, exercise, and smoking should be avoided for at least 30 minutes before BP measurement.
🩺 An appropriately sized cuff should be used.

Question 4

____(a)____ of individuals in the general population are hypertensive.
The prevalence and vulnerability to complications increase with ____(b)____.

Answer 4

(a) 25%
(b) age

Question 5

Blood pressure is a complex trait involving the interaction of multiple genetic and environmental factors that influence two hemodynamic variables: ________.

Answer 5

(1) cardiac output
(2) peripheral vascular resistance

Question 6

“Cardiac output is affected by blood volume which is strongly dependent on ____(a)____ concentrations.”
“Peripheral resistance is regulated predominantly at the level of the ____(b)____ and is influenced by neural and hormonal inputs.”

Answer 6

(a) sodium
(b) arterioles

Question 7

site of production and action of atrial natriuretic peptide

Answer 7

Atrial natriuretic peptide (ANP) is a hormone produced by the heart’s atrial myocytes.

It promotes excretion of sodium (natriuresis) and water (diuresis) by the kidneys, reducing blood volume and pressure.

Question 8

Briefly discuss the pathogenesis of hypertension.

Answer 8

🩺 Approximately 90% to 95% of hypertension cases are classified as essential hypertension, also known as idiopathic hypertension.
🩺 The remaining 5% to 10% of hypertension cases are classified as secondary hypertension. Secondary hypertension results from an identifiable underlying condition, such as kidney disease, endocrine disorders, or the use of certain medications.

Question 9

About 5% of hypertensive persons show a rapidly rising blood pressure that if untreated leads to death within 1 or 2 years. This is termed ________ hypertension.

Answer 9

accelerated/malignant

Question 10

Briefly outline clinical presentations of malignant hypertension.

Answer 10

◾ very high blood pressure with diastolic pressure over 120mmHg
◾ hypertensive retinopathy: bilateral retinal hemorrhages and/or exudates, with our without papilledema [swelling of the optic disk due to increased intracranial prssure]
◾ cardiac symptoms: chest pain, dyspnea, and signs of left ventricular hypertrophy or dilated cardiomyopathy
renal failure
◾ neurological symptoms: occipital headache, visual disturbacnes, cerebral infarction or hemorrhage, hypertensive encephalophathy

Question 11

What is the primary defect in essential hypertension?
(a) hyperthyroidism
(b) acute stress
(c) increased production of catecholamines
(d) renal retention of excess sodium
(e) renal failure

Answer 11

(d) renal retention of excess sodium