Hypertension

Question 1

What BP reading characterizes HTN?

Answer 1

> 140/90 mmHg

Question 2

What are the 3 types of HTN?

Answer 2

1. Essential (primary) HTN
2. Secondary HTN
3. Malignant HTN

Question 3

Essential (Primary) HTN

Answer 3

A. 90% of HTN individuals
B. Cause unknown (triggered by drugs)
C. Controlled with antihypertensive agents

Question 4

Secondary HTN

Answer 4

A. 10% of HTN individuals
B. Cause - renal or endocrine problem
C. Cured by removing cause of HTN

Question 5

Malignant HTN

Answer 5

A. Condition of VERY hight BP
B. May rapidly lead to retinal or renal damage
C. Treated aggresively

Question 6

Systolic arterial pressure

Answer 6

Peak pressure (at beginning of cardiac cycle)

Question 7

Diastolic arterial pressure

Answer 7

Lowest pressure (at resting phase of cardiac cycle)

Question 8

What physiological mechanismscan reduce BP?

Answer 8

1. Reduce sympathetic activity
2. Directly relax smooth muscles of vasculature
3. Decrease Na retention by the kidney

Question 9

What factors influence BP?

Answer 9

1. Cardiac output (HR, stroke volume)

2. Peripheral vascular resistance (degree of dilation or constriction of BV, blood volume)

Question 10

T/F: The smaller the volume, the more constricted the arteries

Answer 10

True (higher BP)

Question 11

T/F: If we dilate (relax) the arteries, the volume is increased

Answer 11

True (lower BP)

Question 12

What drugs lower BP by decreasing sympathetic activity?

Answer 12

1. Clonidine
2. Mecamylamine
3. Prazosin
4. Beta adrenergic receptor antagonists (Beta blockers)

Question 13

Instrinsic sympathetic activity (ISA) of drugs

Answer 13

Produce less cardiac depression and are preferred agents in pts with diminished cardiac reserve, bradyarrhythmias, and vascular disease. Results from partial agonist activity at adrenergic receptors in addition to the antagonist activity

Question 14

An individual suffering from diabetes and hypertension is more likely to be prescribed a beta-blocker with which activity?

Answer 14

A selective B1 adrenergic receptor antagonist

avoid B2 activity in these individuals

Question 15

What drugs directly relax the vascular smooth muscle to decrease BP?

Answer 15

1. Hydralazine
2. Minoxidil
3. Sodium nitroprusside
4. Ca channel blockers (Dihydropyridines)

Question 16

What drugs change Na and H2O balance by the kidney?

Answer 16

1. Thiazide diuretics (Chlorothyazide and Hydrochlorothiazide)
2. Angiotensin converting enzyme (ACE) inhibitors
3. Losartan

Question 17

What is Renin?

Answer 17

An enzyme that cleaves to angiotensinogen and makes peptide angiotensin I

• juxtaglomerula cells release of renin

Question 18

Where is Renin released?

Answer 18

Kidneys (under conditions of low blood volume and low NaCl levels. Relsease is controlled by SNS (B1-adrenergic receptors)

Question 19

What does angiotensin II do?

Answer 19

Increase BP (want to decrease Angio II activity)

Question 20

Aldosterone

Answer 20

Steroid hormone that increases Na+ balance via action in the kidney (increased Na+ volume leads to increased fluid volume)

Question 21

Decreased levels of Angiotensin II has what effect on blood pressure?

Answer 21

Decreased BP