Hypertension Flashcards
major forms of CVD
hypertension, atherosclerosis, ischemic heart disease, peripheral vascular disease, heart failure, cerebrovascular disease
leading cause of death in canada
disease of the heart and cerebrovascular disease (24 % combined)
prevalence is ____________
going up in both males and females- more so in males
how many people are actually aware of their condition
65% treated and controlled, 18% unaware, 14% treated but not controlled, 4% aware, not treated
visits to the doctor
hypertension leading cause - by a lot!!
- more than diabetes
hypertension affects >__/5, what %?
more than 1 in 5 people, 22% Canadians over 20 , but since 18% not aware this number is actually much higher
the lifetime risk of developing hypertension in adults 55-65 with normal BP is?
90%
is hypertension the number one reason for taking medication?
yes
one in how many Americans have hypertension
one in 3
how is more at risk of hypertension
males, African-america, than whites, than hispanic, than Japanese, than Chinese
MAP
(mean arterial pressure) =
the average pressure in a patients arteries during one cardiac cycle. better indicator of the perfusion to vital organs than systolic bp.
found by:
cardiac output x peripheral resistance
cardiac output
= stoke volume x heart rate
peripheral resistance
= (length of vessel x viscosity of blood) / radius ^4
what 4 things regulate MAP?
- sympathetic NS
- RAAS
- renal function
- hormones
which hormones are involved in regulating MAP
epinephrine, vasopressin, angiotensin II
explain the big “factors influencing MAP” chart in you own words
the 2 factors influencing MAP are cardiac output and total peripheral resistance.
- CO is determined by HR and stoke volume.
- HR is determined by either PSNS or SNS/epinephrine. stroke volume is determined by SNS/epinephrine or venous return.
- venous return is a big one. it is affected by blood volume (affected by vasopressin and angiotensin II, salt and water balance), respiratory activity, skeletal muscle activity and cardiac-suction effect.
- on the other side, TPR is determined by arteriolar radius ( determined by skeletal muscle activity leading to local metabolic control, and SNS/epinephrine activity and vasopressin/ angiotensin leading to extrinsic vasoconstriction control) and by blood viscosity which is determined by # of RBC
primary HPT vs secondary
primary 95 % of cases- is idiopathic meaning that there is no known cause and secondary is caused by another issue/disease such s renal disease or CVD, endocrine disorders
causes of primary HPT
cause is not know! however many factors are at play –> individual differences in RAAS, in genes responsible for salt retention etc, in lifestyle choices ( stress, smoking, diet, excersise)
hypertensive individuals often secrete / overproduce?
vasopressin and angiotensin ( causes vasoconstriction and fluid retention)
non-modifiable risk factors of HPT
over 60, males, postmenopausal women, ethnicity, family history
modifiable risk factors
smoking, excersise, sodium intake, obesity, poor diet, stress
how does smoking contribute to HPT
interfere with NO–> impairs endothelial vasodilation
how does renal disease contribute to HPT
reduced blood flow, increased angiotensin, vasoconstriction and electrolyte/water retention, increases BV
is hyperinsulinemia associated with HPT
yes but mechanism is unclear
how would adrenal issues contribute to HPT
increase epinephrine and norepinephrine lead to vasoconstriction and increased cardiac output
how is HPT classified?
readings greater than 140/90 mm Hg (inclusive) are considered hypertensive. this does not mean that Bothe umbers have to be here, could be 140/80 and still hypertensive
why is hypertension a silent killer?
asymptomatic
what happens in response to low NaCl- / low ECF volume and low arterial blood pressure
the kidneys secrete renin, which converted circulating ( from the liver) angiotensinogen into angiotensin I, the lungs secrete converting enzyme to change 1 into 2, and angiotensin 2 acts on adrenal cortex to release aldosterone ( conserve Na+– passively water saved swell), and thirst is triggered and vasopressin release ( to reabsorb more water ( aquaporins) ) and acts on arteries to vasoconstriction –> all these in place to save body from harmful low BP
where is vasopressin released from
the posterior pituitary ( made in the hypothalamus)
what organs are affected by hypertension
brain - hemorrhage and stroke
kidney- renal failure and proteinuria
heart- CHD, CHF, LVH
eyes - retinopathy ( damage to the retina)
peripheral vascular disease ( blood circulation disorder)
what is top number reading
systolic
what is bottom number reading
diastolic
normal systolic
90-119
normal diastolic
60-79
stage 1 hypertensive
140-156/ 90-99
stage 2 HPT
160-179/ 100-109
stage 3
> 180/ >110
cerebrovascular diseases
diseases or conditions relating to blood supply to the brain –> stoke, dementia, hemorrhage
ACC stands for?
associated clinical conditions
list some ACC and target organ damage (TOD) that can occur from HPT
CVD - coronary artery disease, left ventricle hypertrophy, heart failure cerebrovascular Diseases retinopathy nephropathy peripheral artery disease
TOD
TOD is the structural and functional impairment of major body organs due to elevated blood pressure (BP).
