Hypertension Flashcards
What is the minimum value of diastole & systole for hypertension?
Diastole pressure >= 90mmHg
Systole pressure >= 140 mmHg
Value of diastole & systole for stage II hypertension
Diastole Pressure >= 100 mmHg
Systole Pressure >= 160 mmHg
T/F: hypertension is caused by one factor
False
Equation to calculate blood pressure?
Cardiac output x Total peripheral resistance
What are factors that influence the BP?
cardiac output
blood vessel tone - determine TPR
kidney
hormone
What are the factors influence stroke volume, which affect cardiac output?
preload - the amount of blood returned to heart
afterload- the resistance force that left ventricle has to overcome to eject blood
the cardiac contractility
What are circulating regulators that increase the TPR?
hormone: catecholamine family (epinephrine) & angiotensin II
What systems does the catecholamine (epinephrine) stimulate?
HR, SV, venous tone, TPR
How does the kidney regulate BP when BP is high?
T/F: kidney can bring BP down even though TPR/CO is very high
by increase Na+ & water excretion
What effects the chronic hypertension have on the kidney function?
damage the renal tubules & renin-angiotensin- aldosterone (RAA) system -> reduce the kidney’s ability to excrete sodium
What are the local regulators that inhibit/decrease TPR?
NO
endothelin
[H+]
adenosine
oxygen
prostaglandins
What are drugs that increase/decrease TPR?
alpha-1 : increase
beta-2: decrease
What are the factors influence the venous return?
blood volume & venous tone
What are the factors that increase the blood volume?
thirst
Na+ & water renal retention
What are the factors that stimulate sodium & water renal retention?
What are the factors that inhibit sodium & water renal retention?
aldosterone, ADH & sympathetic system
natriuretic peptides
Drugs that block the formation of angiotensin II or block aldosterone receptors, _____ blood volume
reduce
where is the location of baroreceptors?
What system does baroreceptor activate (parasympathetic/ sympathetic)?
aortic & carotid sinuses
Both. stimulate parasympathetic system & inhibit sympathetic system
What happen to baroreceptors for chronic hypertension?
desensitized baroreceptor
T/F: baroreceptors respond to the long-term increase in BP
False
What
Describe the activation pathway of angiotensin II
Angiotesinogen increases -> angiotensin I activation & react with ACE in the lung -> angiotensin II ->
What chemical in female that help reducing hypertension?
estrogen
What is the other name for ADH?
vasopressin or arginine vasopressin
Where is the ADH released?
hypothalamus (pituitary gland)
What are the effects of angiotensin II?
What do all these effects have in common?
1) stimulate adrenal cortex -> aldosterone
2) stimulate pituiatary gland -> ADH & thirst
3) vasoconstriction of arterioles
4) stimulate sympathetic nervous system (release of norepinephrine)
5) stimulate kidney
6) stimulate heart contractility & ventricular hypertrophy
- > increase Na+ & water retention -> increase BP
essential hypertension
the exhibition of BP with no specific physical findings
most common form of hypertension (95% of the case)
Aldosterone________Na+ & water retention, ______ water loss in urine, ________ blood volume
increase
reduce
increase
T/F: Essential hypertension is high concordance in identical twins
T/F: ____________ is higher in African american than other races
True
True
how does insulin resistance cause hypertension?
type 2 diabetes have high blood sugar due to excessive insulin not being taken -> increase SNS tone & increase vascular resistance
T/F: Stress can cause abnormal response in BP increase
True
Why does obesity cause hypertension?
increase blood viscosity due to the adipocyte secretion of protein as profibrinogen
increase release of angiotensinogen from adipose tissue
increase blood volume to body mass
high incidence of metabolic syndrome - high triglyceride, low LDL, glucose intolerance
What are the primary abnormalities in blood vessel system causing essential hypertension?
reduce nitric oxide secretion
increase endothelin production
Ion channels defects
hyperresponsiveness to catecholamine
What are the primary abnormalities in kidney system causing essential hypertension?
RAA system dysfunction
ion channels defects (Na+/K+/Cl-)
T/F: Less than 60% of American over 60 will have essential hypertension
False
What is the characteristic of essential hypertension in age-systole/diastole relation?
Systolic rise with age while diastolic pressure rise and tend to fall slightly after 50
In younger hypertensive patients, high BP is driven by _______ CO & _____ TPR.
With increasing age, the effect of CO _______ & TPR_________
high & normal
declines & increases
What is the cause of renovascular hypertension?
What are the consequences of this disease?
stenosis of one or both renal arteries
obstruct the blood flow to kidney -> reduce excretion of Na+ & water and increase renin production
How can you detect renovascular hypertension?
detecting murmur by stethoscope on spleen, renal arteries or abdominal aorta
abdominal bruit
the murmur sound heard at renal arteries, spleen or abdominal aorta due to the turbulence as blood squirt through narrowing renal artery
coarctation of aorta
what is the consequence of this disease?
the narrowing of part of aorta
1) the BP in head, arm & aortic arch is higher than the descending aorta & distal branches
2) the lower flow to kidneys stimulate renin production -> increase Na+ & water reabsorption
3) the baroreceptors in carotid & aortic arch desensitize to high BP
pheochromocytoma
Symptoms??
tumor of adrenal medulla
increase release of catecholamine (epinephrine) -> intermittent vasoconstriction, tachycardia,
what is the cause of Cushing’s syndrome?
T/F: This disease doesn’t cause hypertension
glucocorticoid excess
False
What are the consequences of hypertension?
left ventricular hypertrophy
aneurysm
organ damages (kidney, retina, cerebrovascular, aorta & peripheral vascular)
what type of ventricular hypertrophy it is in hypertension?
aneurysm
What does it can cause?
ballon-like swelling in an artery
stroke (in brain or abdominal aorta) when weakened wall burst
What are the non-pharmacologic treaments for hypertension?
diet (high veggies & low fat + sodium) + potassium supplements
exercise
reduce/quit smoking & alcohol
reduction of stress
What are the pharmacological treaments for hypertension?
diuretics
beta 2-blocker drug
ACE inhibitors & Angiotensin II receptors blockers
Ca2+ channel blocker
alpha-adrenergic receptors inhibitors
What is the effect of diuretics on alleviating hypertension?
reduce blood volume -> decrease BP
Tumor in adrenal cortex can cause excess _________
aldosterone
T/F: Thyroid hormone abnormalities can cause hypertension
Renin is always in the blood stream
True
True
Renin
the enzyme that circulating in blood to convert angiotesinogen to angiotensin I
