Hypertension Flashcards
Hypertension can be classified as a BP over?
140/90 mmHg
Hypertension is a risk factor for?
- cerebral haemorrhage
- atheroma
- renal failure
- sudden cardiac death
How is hypertension classified?
- cause ( primary or secondary)
- consequence (benign or malignant)
How is blood pressure calculated
= CO X SVR
What factors effect cardiac output?
- heart rate
- contractility
- blood volume
What factors effect peripheral resistance?
- vasoconstrictors (angiotensin II or catecholamines)
- vasodilators (nitric oxide or prostaglandins)
Explain the RAAS?
- renin released from kidneys
- angiotensinogen converted to angiotensin I
- ACE converts to angiotensin II
- Vasoconstrictor properties & release of aldosterone
- salt and water retention
What is salt sensitive hypertension?
- can be a primary cause of hypertension
- increase in dietary salt intake leads to increase in BP
- Controlled by reduced salt diet
What is secondary hypertension? name some examples
- underlying disease is implicated
- e.g. renal disease, endocrine disease aortic disease
How does renal disease cause hypertension?
- reduced renal blood flow
- excess renin release
- salt and water overload
- increases BP
Examples of endocrine diseases that can cause hypertension?
- Conn’s syndrome
- Cushings syndrome
- pheochromocytoma
What is the effect of Conn’s syndrome?
- excess aldosterone
What is the effect of Cushings syndrome?
- excess corticosteroid
What is benign hypertension?
- serious life theratening morbidity
- asymptomatic
What can benign hypertension cause?
- as it is asymptomatic it can go a long period undetected
- may lead to left ventricular hypertrophy
- renal disease
- cardiac failure
What is the effects of left ventricular hypertrophy?
- increased LV load
- poor perfusion
- interstitial fibrosis
- pulmonary oedema
What is a complicated atheroma?
- abnormal accumulation of material in inner layer of arterial wall
What is aortic dissection
- injury ‘rip’ to inner layer of aorta allows blood to flow between layers of aortic wall (Creates a false lumen)
What is the microvascular effect of hypertension?
- blood vessel wall changes
- thickening of media in smooth muscle
- hyaline arteriosclerosis
What is arteriolosclerosis
Arteriolosclerosis is a form of cardiovascular disease involving hardening and loss of elasticity of arterioles or small arteries and is most often associated with hypertension and diabetes mellitus
What should you do before using an automated blood pressure monitor?
- check the pulse
- if irregular do BP manually
How do you diagnose hypertension?
- ABPM (2 measurements per hour)
- HBPM (2 consecutive seated, recorded twice a day for atlas 4 days)
What are definitions of stage 1 hypertension?
- Clinical BP >140/90mmHg
- ABPM daytime >135/85mmHg
What are the definitions of stage 2 hypertension?
- Clinical BP >160/100mmHg
- ABPM daytime >150/95mmHg
