Hypertension Flashcards
When BP goes up…
HR goes down
When BP goes up…
HR goes down
Prehypertensive:
120-139 / 80-89
Stage I Hypertension
140-159 / 90-99
Stage II Hypertension
> 160 / >100
What is BP?
Force exerted against the walls of the arteries and veins by the blood as it’s being pumped out of the heart.
Systolic Pressure:
highest amount of pressure exerted on the arterial wall at peak of ventricular contraction
Diastolic Pressure:
Lowest pressure exerted during ventricular relaxation
MAP: Mean Arterial Pressure
average amount of pressure exerted throughout cardia cycle.
MAP Formula
1/3 (SBP+2DBP)
Pulse Pressure Formula
SBP - DBP
MAP is Measured as
the cardiac output multiplied by the peripheral vascular resistance (COxPVR)
Why is MAP important?
- shows entire cardiac cycle
- monitors perfusion of organs
Normal MAP:
70-110
MAP that can perfuse all organs:
> 60
MAP that is dangerous
How is BP controlled/maintained
SNS
Vascular Endothelium
Renal System
SNS
baroreceptors in the carotid arteries can activate SNS
Vascular Endothelium:
produces several vasoactive substances
Renal system
- controls extracellular fluid
- renin, angiotensin, aldosterone system
- prostaglandins - vasodilators
Primary HTN:
^ BP without a SINGLE identified cause (diabetes)
Secondary HTN:
^ BP with specific cause which can be corrected (physiological issue)
Manifestations of HBP
HA, nocturia, mental status change (later on), n/v, visual changes, papilledema
Manifestations of HBP
HA, nocturia, mental status change (later on), n/v, visual changes, papilledema
Prehypertensive:
120-139 / 80-89
Stage I Hypertension
140-159 / 90-99
Stage II Hypertension
> 160 / >100
What is BP?
Force exerted against the walls of the arteries and veins by the blood as it’s being pumped out of the heart.
Systolic Pressure:
highest amount of pressure exerted on the arterial wall at peak of ventricular contraction
Diastolic Pressure:
Lowest pressure exerted during ventricular relaxation
MAP: Mean Arterial Pressure
average amount of pressure exerted throughout cardia cycle.
MAP Formula
1/3 (SBP+2DBP)
Pulse Pressure Formula
SBP - DBP
MAP is Measured as
the cardiac output multiplied by the peripheral vascular resistance (COxPVR)
Why is MAP important?
- shows entire cardiac cycle
- monitors perfusion of organs
Normal MAP:
70-110
MAP that can perfuse all organs:
> 60
MAP that is dangerous
How is BP controlled/maintained
SNS
Vascular Endothelium
Renal System
SNS
baroreceptors in the carotid arteries can activate SNS
Vascular Endothelium:
produces several vasoactive substances
Renal system
- controls extracellular fluid
- renin, angiotensin, aldosterone system
- prostaglandins - vasodilators
Primary HTN:
^ BP without a SINGLE identified cause (diabetes)
Secondary HTN:
^ BP with specific cause which can be corrected (physiological issue)
Preeclampsia
^ BP during pregnancy usually after 20 weeks, possible organ damage especially kidneys. Very Dangerous.
Manifestations of HBP
HA, nocturia, mental status change (later on), n/v, visual changes, papilledema
Secondary HTN Examples
- Coarctation or congenital narrowing of the aorta
- S/E of drugs or hormones
- Traumatic brain injury, tumors
- Glomerulonephritis, Kidney disease
- Cirrhosis of the liver
HTN Crisis Manifestations
- Encephalopathy (HA N/V Seizures, confusion, coma)
- Renal Insufficiency
- Angina, MI, SOB
HTN Crisis Treatment:
- Nitroprusside sodium: vasodilator given IV, closely monitored/titrated
- Labetalol: mixed alpha and beta adrenergic blocker given IV
Beta Blockers:
slows hr, uses less force, monitor HR and decreased CO
ACE Inhibitors:
Stops veins from vasoconstricting (watch for OH)
Diuretics:
make you pee, some are potassium sparing
