Hypertension Flashcards
What is Isolated Systolic HTN? / per JNC 8, if someone is under 60, what is their goal SBP?
SBP OVER 140 mmHg but DBP UNDER 90 mmHg / 140 mmHg
____% of HTN patients have Essential HTN / factors that cause Primary HTN / what is the onset / diagnosed by
95% / genetic and environmental / 25 to 50 / 2 readings of 140/90 or higher on 2 or more visits
____% of HTN patients have Secondary HTN / list the causes of Secondary Hypertension
5% / Hyperaldosteronism, Renal Vascular Disease, Renal Parenchymal Disease (CKD), Coarctation of Aorta, Pheochromocytoma, Drug SE, Thyroid Disease, Hyperparathyroidism, Apnea
In Hyperaldosteronism, the _____________ produce too much Aldosterone / What causes this?
Adrenal Glands / Adrenal adenoma or adrenal hyperplasia
Symptoms associated with hyperaldosteronism:
Muscular weakness, polyuria, nocturia, metabolic alkalosis
Describe Renal Vascular Disease:
Atherosclerotic stenosis of renal arteries cause them to produce too much Renin. Renin –> Antiogension II –> vasoconstriction / salt and water retention
What is unique about the onset of Renal Vascular Disease? / Symptoms? / Dx
Onset is sudden and occurs earlier than usual (before 20) or later than usual (after 50) / Fibromuscular dysplasia in young F, pulm edema surge w/BP surg, bruits / Angiography
What is the most common kind of Secondary HTN?
Renal Parenchymal Disease = Chronic Kidney disease
How does CKD cause increased BP? / Symptoms?
Increased intravascular volume or increased activity of renin/angiotensin/aldosterone / Edema, hematuria, proteinuria, lipid uria, HTN
Describe Coarctation of the Aorta / typically seen in which demographic / Symptoms
Congenital narrowing of the aortic arch distal to L subclavian –> collateral circ develops through intercostal A / infants with high BP / LE pulses are less than UE (Radial Femoral Delay), webbed neck, midline back bruit, cardiac failure in infants
Dx for Coarctation of the Aorta
Echo/Doppler, XR shows scalloping of the ribs due to big intercostal A
What is Pheochromocytoma / how does it cause HTN / Triad of symptoms? / other symptoms?
Rare adrenal tumor that produces excessive catecholamines (NE and E) and chronic vasoconstriction / Triad: episodic HA, palpitations, sweating / Orthostatic BP drop, postural HTN.
Drugs that can cause HTN / mechanisms by which they cause it:
NSAIDs, estrogen, antidepressants, erythropoietin, cyclosporines, decongestants, cocaine, ETOH / vasoconstriction or increased Na+ retention
Hypothyroid symptoms:
Weakness, fatigue, cold intolerance, constipation, weight gain, depression, SLOW pulse
Hyperthyroid symptoms / Cardiac-Specific?:
Overstimulation of metabolism (wt. loss, exacerbated sympathetic innervation) / Forceful heartbeat, PACs, exertional dyspnea, S-fib, sinus tachycardia
Hyperparathyroidism leads to / what often causes it / what can it cause / who does this occur to / don’t treat with
Excess calcium production by the kidneys / adenoma or hyperplasia of parathyroid gland / kidney stones / women over 60 / thiazides
Hyperparathyroidism can do what to bone density? / treat with? / how does it cause HTN
decrease it / bisphosphonates / interferes with renin-angiotensin system
How does sleep apnea lead to HTN?
Increased sympathetic activity, intrathoracic pressure changes, inflammation, oxidative stress
Acromegaly is caused by / signs of? / Tx
Pituitary adenoma causes increased growth hormone / excessive growth of hands, feet, jaw, heart / Remove tumor early
