Hypertension Flashcards
What is hypertension(High blood pressure)?
Blood pressure in the arteries are elevated.
Does high blood pressure cause any symptoms?
Nope. Long term high blood pressure then risk of coronary artery disease, stroke, heart failure, peripheral vascular disease, vision loss, and chronic kidney disease
High blood pressure is classified as? What percent of hypertension is primary and what are the factors?
Primary/essential high blood pressure and secondary high blood pressure.
90-95% are primary due to lifestyle (excess salt, smoking,alcohol, weight) and genetic factors.
Define secondary high blood pressure
Blood pressure due to unidentifiable cause like chronic kidney disease, narrowing of the kidney arteries, an endocrine disorder, or the use of birth control pills.
How is blood pressure measured? Normal blood pressure, and high blood pressure limit?
The systolic and diastolic pressures, which are the maximum and minimum pressures.
Normal blood pressure at rest is 100–140 mmHg systolic and 60–90 mmHg diastolic.
High blood pressure is if the resting blood pressure is at or above 140/90 mmHg for most adults.
Percent rate at which hypertension affects global population? In 2010?
16 and 37%. In 2010 hypertension in 18% of all deaths (9.4 million globally)
What is more accurate than the regular blood pressure treatment? Why?
Ambulatory blood pressure monitoring over a 24-hour period, reduces nervousness and anxiety
Signs and symptoms of hypertension What are 6 of the signs and symptoms and what is it usually associated with?
Rarely any symptoms, identified through screening, or seeking healthcare for an unrelated problem.
Some report headaches, dizziness, vertigo, tinnitus (buzzing or hissing in the ears), altered vision, fainting episodes; all associated with anxiety.
How is hypertension detected during physical examination?
Changes in the optic fundus seen by ophthalmoscopy.
The severity of the changes of hypertensive retinopathy (damage to retina due to high blood pressure) is from I–IV
The severity of the retinopathy = duration or the severity of the hypertension.
Secondary hypertension symptoms and 5 examples
Hypertension+ more signs and symtoms=secondary hypertension.
Examples:
Cushing’s syndrome: causes truncal obesity, glucose intolerance, moon face, a fat hump by the neck/shoulder, and purple abdominal stretch marks. Hyperthyroidism: weight loss with increased appetite, fast heart rate, bulging eyes, and tremor.
Renal artery stenosis (RAS): a localized abdominal bruit to the left or right of the midline or in both locations Coarctation of the aorta: decreased blood pressure in the lower extremities, absent femoral arterial pulses. Pheochromocytoma: abrupt (“paroxysmal”) episodes of hypertension with headache, palpitations, pale appearance, and excessive sweating.
What is hypertensive crisis?
Severely elevated blood pressure (equal to or greater than a systolic 180 or diastolic of 110)
What are the two categories of hypertensive crisis?
Hypertensive urgency and hypertensive emergency
Define Hypertensive urgency What is given usually to lower BP within 24 to 48 hours?
No evidence of end organ damage resulting from the elevated blood pressure. Oral medications are used to lower the BP gradually over 24 to 48 hours.
Define Hypertensive emergency What organs are affected? What symptoms are produced?
Evidence of direct damage to 1 or more organs like the brain, kidney, heart and lungs, producing symptoms like confusion, drowsiness, chest pain and breathlessness. Blood pressure must be reduced rapidly to stop ongoing organ damage
What are the 3 classifications for hypertension in pregnancy? Which one is the most common and the percent rate?
Classified as pre-existing hypertension, gestational hypertension, or pre-eclampsia
Pre-eclampsia occurs in 5% of pregnancies and is responsible for approximately 16% of all maternal deaths globally.
Define pre-eclampsia What severe condition can it lead to and describe 6 complications
Occurs in 2nd half of pregnancy and following delivery by increased blood pressure and the presence of protein in the urine.
Pre-eclampsia can occasionally progress to a life-threatening condition called eclampsia, which is a hypertensive emergency and has several serious complications including vision loss, brain swelling, seizures, kidney failure, pulmonary edema, and disseminated intravascular coagulation (a blood clotting disorder).
5 reported symptoms of pre-eclampsia
no symptoms detected by routine screening but common ones are headache, visual disturbance, vomiting, pain in stomach and swelling
What life threatening condition can pre-eclmpsia progress to?
Eclampsia, a hypertensive emergency, includes vision loss, brain swelling, seizures, kidney failure, pulmonary edema and disseminated intravascular coagulation
What is gestational hypertension?
Hypertension during pregnancy without protein in the urine.
Describe hypertension in infants and children
Infants: Failure to thrive, seizures, irritability, lack of energy, and difficulty in breathing
Children: headache, unexplained irritability, fatigue, failure to thrive, blurred vision, nosebleeds, and facial paralysis.
What are the causes of primary hypertension
Genetic variants and environmental factors.
DNA methylation might affect in some way linking common genetic variation to multiple phenotypes
Test performed for sentinel SNP (known and new) showed that genetic variants singly or in aggregate contribute to risk of clinical phenotypes related to high blood pressure
High salt intake raises the blood pressure in salt sensitive individuals; lack of exercise, obesity, and depression, caffeine consumption, vitamin D deficiency Insulin resistance, sugar
Low birth weight, maternal smoking, high blood urea and lack of breast feeding may be risk factors for adults
Blood pressure higher in winter
What are the causes of secondary hypertension?
Occurs because of an identifiable cause.
Kidney disease: common
Endocrine conditions: Cushing’s syndrome, hyperthyroidism, hypothyroidism, acromegaly, Conn’s syndrome or hyperaldosteronism, hyperparathyroidism and pheochromocytoma.
Other: obesity, sleep apnea, pregnancy, coarctation of the aorta, excessive eating of liquorice, excessive drinking of alcohol, and certain prescription medicines, herbal remedies and illegal drugs
Arsenic exposure through drinking water
Diagnosis of hypertension in Kidney, Endocrine, Metabolic, Other and Lab tests
Complete history, physical examination
Kidney:Microscopic urinalysis, protein in the urine, BUN and/or creatinine
Endocrine: Serum sodium, potassium, calcium, TSH
Metabolic: Fasting blood glucose, HDL, LDL, and total cholesterol, triglycerides
Other: Hematocrit, electrocardiogram, and chest radiograph
Lab tests performed to check damage in heart, kidney or eyes
Which age group is secondary hypertension common for?
Preadolescent children; usually a kidney case
