Hypertension

Question 1

There are two blood pressure regulatory systems. One short term and one long term. What are they?

Answer 1

Short term blood pressure regulation is achieved via the sympathetic nervous system.
Long term blood pressure regulation is achieved via the renal system

Question 2

How does the sympathetic system regulate blood pressure?

Answer 2

Baroreceptors send blood pressure info to the brain. Sympathetic nerves adjust catecholamines to regulate vasoconstriction, heart beat, and cardiac output.

Question 3

How does the renal system regulate blood pressure?

Answer 3

Juxtaglomerular cells have baroreceptors. They sense low renal blood flow. In response they secrete renin to increase blood flow to the kidney and get proper filtration.

Question 4

Angiotensinogen is produced where?

Answer 4

The liver

Question 5

Angiotensinogen is converted to angiotensin I by what?

Answer 5

renin

Question 6

Angiotensin I is converted to angiotensin II by what?

Answer 6

ACE- angiotensin converting enzyme

Question 7

What does angiotensin II do?

Answer 7

Ultimately, it increases blood pressure. It mediates vasoconstriction, increases sodium reabsorption, and increases water retention. Structural remodeling can also occur.

Question 8

T/F angiotensin II promotes aldosterone release from the adrenal cortex?

Answer 8

True

Question 9

Diuretics to what?

Answer 9

They lower blood pressure by depleting the body of Na+, water follows, and blood volume decreases

Question 10

Sympathoplegic agents do what?

Answer 10

They lower blood pressure by reducing peripheral vascular resistance and diminishing cardiac output (they can mimic or block the effects of sympathetic agents)

Question 11

What do direct vasodilators do?

Answer 11

They lower blood pressure by relaxing vascular smooth muscle

Question 12

What does blocking angiotensin II production or activity do?

Answer 12

It lowers blood pressure by reducing vascular resistance and blood volume

Question 13

If you’re on a diuretic, you should eat bananas so you don’t suffer from potassium depletion.

Answer 13

Great, I love bananas.

Question 14

Sympathoplegic agents are generally inhibitory. Explain how they work.

Answer 14

They can act on the CNS and produce sedation and depression.
They can reduce the release of epinephrine from the sympathetic nerve endings and produce hypotension.
They can block selective adrenoreceptors.
All in all this leads to sodium retention.

Question 15

Sympathoplegic agents in the CNS do what to alpha 2 receptors?

Answer 15

They activate them, which blocks the release of sympathetic neurotransmitters

Question 16

What are some ways that sympathoplegic agents can influence the alpha 2 receptors?

Answer 16

It can block transmitter uptake into vesicles
It can replace the transmitters inside the vesicles with something that isn’t a neurotransmitter
It can diminish the storage of catecholamines in the vesicles.

Question 17

Another way to treat hypertension with sympathoplegic agents is to block beta1 receptors. Why does this work?

Answer 17

Beta-1’s are found on the heart. Activating them will increase heart rate and cardiac output. By blocking them, cardiac output decreases.

Question 18

Another way to treat hypertension with sympathoplegic agents is to block alpha1 receptors. Why does this work?

Answer 18

alpha1 receptors, when activated, cause vasoconstriction. Block vasoconstriction, promote vasodilation- decrease resistance and you get lower blood pressure.

Question 19

Another way to treat hypertension is with direct vasodilators. A few things that can do this are listed on the reverse.

Answer 19

Nitric oxide pro drugs
Drugs that reduce Ca++ influx into vascular smooth muscle
Drugs that hyperpolarize the membrane of vascular smooth muscle (by opening of K+ channels)
Activation of dopamine receptors (similar response to B2 adrenergic receptor agonists)

Question 20

What does NO release from endothelial cells produce?

Answer 20

Muscle relaxation

Question 21

There are several different ways to block angiotensin II production or activity. What are the four ways to do it?

Answer 21

Angiotensin converting enzyme (ACE) inhibitors
Competitive antagonist of angiotensin receptors
Renin inhibitors
Aldosterone inhibitors

Question 22

What does ACE do to bradykinin. What does that lead to?

Answer 22

Bradykinin is a vasodilator

ACE degrades bradykinin. If you inhibit ACE then you potentiate vasodilation

Question 23

Do competitive antagonists of angiotensin receptors affect bradykinin metabolism like ACE inhibitors do?

Answer 23

Nope, they’re more selective. They’re blocking the AT1 receptor only.