Hypertension Flashcards
What is the number of people who are affected by HTN and aren’t aware?
30%
How many people treated for hypertension achieve control?
34%
Are those in control of hypertension more at risk than those who are normotensive?
No
What are the risk factors of Hypertension?
CHD, Heart Failure, Stroke, Renal Failure , Blindness
High Diastolic blood pressure is a risk for what?
Rupture
How many times should blood pressure be measured with the same cuff?
2 times
What is a normal blood pressure?
Below 120/80
Which is more of a concern a high systolic or a high diastolic?
High Diastolic
What is Prehypertension?
120-129/80-89
What is Stage 1 Hypertension
140-159/90-99
What is Stage 2 Hypertension
Greater than or equal to 160/ Greater than or equal to 100
What is the cause of Primary Hypertension?
No Known cause
What can be the cause of Secondary Hypertension?
Neurological disorders, Kidney Disorders, Pregnancy, Steroids, Medication, etc.
What is the lowest pressure diastolic pressure should be?
60
Why is Diastolic Pressure necessary?
It keeps blood vessels open during ventricular relaxation.
What is Stroke Volume?
The amount of blood pumped out of the left ventricle with each heart beat
What is Total Peripheral Resistance?
The resistance of the muscular arteries to blood being forced through them.
What is a local factor affecting blood pressure?
Resistance to Insulin, Arteriosclerosis, Atherosclerosis
Diabetics are typically on what other medications beside Insulin?
ACE Inhibitors, Statins possible
What factors effect the blood pressure of the elderly?
increased Plaque, collagen deposits, impaired vasodilation, decreased elasticity of blood vessels.
Should Preload and Afterload be the same or different?
Preload and Afterload should be roughly the same
How does Primary Hypertension develop?
Overstimulation of alpha-, beta-andrenergic receptors
Altered function of Renin-Angiotensin-Aldosterone
Other Chemical Mediators
Insulin Resistance, Hyperinsulinemia, endothelial funcion
What organ is primarily affected by high blood pressure
Kidneys
What is one of the early signs of HTN?
Nocturia
If High blood pressure has an identified cause is it Primary or Secondary HTN?
Secondary
What are identifiable causes of Secondary HTN?
Kidney Disease, Endocrine Disorders, Neurological Disorders, Drugs, and Pregnancy
In a percentage, how much extra fluid does a woman have during pregnancy?
50%
What is the Number one effect of Hypertensive emergency?
Stroke
What is a Hypertensive Emergency?
> 180/>120
Effects of Hypertensive encephalopathy?
Extremely High BP Altered LOC Increased ICP Papilledema Seizures
What can occur if a Hypertensive emergency is prolonged?
Acute renal failure
Who Does HTN Primarily affect?
Middle-aged, Older Adults
List the risk of HTN based on ethnicity
African-Americans, Hispanics, Native Americans, Alaskan Natives, Whites
What are modifiable risk factors of HTN?
High sodium; low potassium, calcium, magnesium Obesity/Insulin Resistance Excess Alcohol consumption Sedentary Lifestyle Smoking Stress
What are non-modifiable risk factors of HTN?
Genetic factors
Family History
Age
Race
What are target Organs affected by BP?
Heart-Has to work Harder
Brain- Pressure, Stroke Risk
Kidneys- Pressure, Working harder
Retina-Pressure
Is an Orthostatic blood pressure measurement necessary?
Yes
What things should be noted in a Health History?
Heart or renal Disease, Headache or neck pain, Diabetes, Current Meds, and Family History
Clinical Manifestations of Hypertension
Initially elevated BP, Retinal Changes, Renal Insufficiency, Blurry Vision, Elevated BUN and Creatinine
What diagnostic tests are utilized with HTN?
ECG, Urinalysis, Blood Glucose, Hematocrit, Renin Level, Cholesterol and Triglycerides could be elevated, Serum Potassium, Serum creatinine.
What diagnostic tests differentiate secondary from primary intention HTN?
Urinalysis, Blood Chemistries, Renal Arteriogram, CT scan or MRI
What are some lifestyle modifications necessary for managing HTN?
Limiting Sodium intake, losing 10lbs helps control blood pressure, no more than 2 alcoholic drinks per day, physical activity, and stress reduction
What is the first med given for HTN?
Thiazide Diuretics
What other meds can be prescribed alongside Thiazide Diuretics
ACE Inhibitors
What is the first priority before diuretics are prescribed?
Lifestyle modifications
When planning weight loss with patient what weight increments should be used?
5-10lb weight increments
When dealing with elderly Hypertensive patient, what medication consideration is important?
MONOTHERAPY, reduce medicinal regimen as much is possible. Elderly have a lot of meds to take. Also some elderly are on fixed incomes and can’t afford all of their meds.
Should the patients BP cuff be brought in with them?
Yes, sometimes manual cuffs may not be calibrated so it is important to see how far off their cuff is in BP measurement.
