Hypertension Flashcards
1
Q
WHAT IS HYPERTENSION ?
A
- a systolic BP >140 or a diastolic BP > 90 based on average of at least 3 readings
- 120-139 and /or 80-90 is prehypertensive
- 140-159 and /or 90-99 is stage 1 hypertension
- > 160 and /or >100 is stage 2 hypertension
2
Q
HYPERTENSION
A
- called the silent killer
- the WHO identifies it as being responsible for 62% of cerebrovascular disease and 49% of ischemic heart disease
- CDC estimates that approximately 1 in 4 adults are hypertensive, many do not realize
3
Q
WHAT IS BLOOD PRESSURE
A
- the force exerted against the walls of the arteries and veins by the blood as it’s being pumped from the heart
- remember your physics it’s also the pressure exerted by the walls of the arteries and veins against the blood
4
Q
BLOOD PRESSURE
A
- systolic pressure is the highest amount of pressure exerted on the arterial wall at the peak of ventricular contraction
- diastolic is the lowest pressure exerted during ventricular relaxation
- MAP- mean arterial pressure is the average amount of pressure exerted throughout cardiac cycle
5
Q
MAP
A
-is the cardiac output multiplied by the peripheral vascular resistance
MAP= DBP+ 1/3(SBP - DBP)
MAP= 100 + 1/3(120-100)
=106.667
6
Q
WHY IS MAP IMPORTANT
A
-gives us a picture of the entire cardiac cycle
- monitors the perfusion of organs
MAP 70-110 is normal , >60 is enough to perfuse all organs, less is potentially bad
- 110= organ death
7
Q
HOW IS BP CONTROLLED/ MAINTAINED
A
- sympathetic nervous system
- 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
8
Q
HYPERTENSION TYPES (3)
A
- PRIMARY HTN- elevated BP without a single identified cause
- SECONDARY HTN- elevated BP with specific cause which can be identified and corrected
- PREECLAMPSIA - elevated BP during pregnancy, usually after 20 weeks . possible organ damage especially kidneys. very dangerous or fetus death
9
Q
PRIMARY HTN
A
- there is no one direct cause that HTN can be attribute to
- there are contributing factors though
- elevated SNS activity
- elevated sodium retaining/vasoconstriction hormones
- increased body weight
- diabetes
- tobacco/alcohol consumption
10
Q
RISK FACTORS
A
age body weight (not just fat) diet exercise genetics sex( men at higher risk) ethnicity/socioeconomics alcohol/tobacco stress
11
Q
MANFESTATIONS
A
- early on, asymptomatic, only high BP
- headache
- nocturia
- mental status changes later
- nausea, vomiting
- visual changes, papilledema( swelling of optic nerve )
12
Q
SECONDARY HTN
A
- coarctation or congenital narrowing of aorta
- side effect of drugs or hormones (estrogen,corticosteroids)
- traumatic brain injury, tumors
- glomerulonephritis, kidney disease
- cirrhosis
13
Q
HYPERTENSIVE CRISIS/ EMERGENCY
A
- developes over several hours, days, or e/en weeks
- situation when BP rises to severe levels ( 180/120) in book
- The rate of rise is more important than the end value however pts with chronic HTN typically tolerate higher BPS normally
14
Q
HYPERTENSIVE CRISIS
A
- typically in pts with history of HTN who do not adhere to medical regimen or whose BP is undermediated
- can also result from drug use (caocain,lsd)
15
Q
HTN CRISIS MANIFESTATIONS
A
- encephalopathy - increased cerebral capillary permeability
- headache
- nausea, vomiting
- seizures, confusion, coma, LOC changes
- renal insufficiency
- angina, MI, chest pain, SOB
