Hypertension Flashcards
Most common primary diagnosis in the United States.
Responsible for an annual worldwide death rate of 7 million
Hypertension
What 4 things can hypertension lead to in terms of morbidity/mortality?
Increases morbidity and mortality associated with heart disease, kidney disease, peripheral vascular disease, and stroke
_______is a range of pressures between normal and stage 1 hypertension in an effort to initiate interventions early enough to prevent or deter progression of the disease process
Prehypertension
Determined by the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure
Hypertension
What are the ranges for hypertension in terms of normal, prehypertension, stage 1 and stage 2?
Normal: SBP <120; DBP <80
Prehypertension: SBP 120-139 ;DBP 80-89
Type 1: SBP 140-159; DBP 90-99
Type 2: SBP > 160; DBP >100
Primary hypertension is also called ______hypertension, is an _______ disorder, and most ______form of hypertension
essential; idiopathic; common
In primary hypertension, it is rare prior to the age of ____ and _______ is a major risk factor for cardiovascular disease
10; systolic BP
What are the 3 subtypes of primary hypertension?
isolated systolic
isolated diastolic
combined systolic and diastolic hypertension
systolic BP is ≥140 mm Hg while diastolic pressure remains <90 mm Hg
isolated systolic hypertension
diastolic pressure is ≥90 mm Hg with a systolic pressure of <140 mm Hg
isolated diastolic hypertension
both systolic and diastolic exceed prehypertension levels
combined systolic and diastolic hypertension
What are some non modifiable risk factors for primary hypertension?
Family history
Age
Ethnicity/Genetics
What are some modifiable risk factors for primary hypertension?
Dietary factors Sedentary lifestyle Obesity/weight gain Metabolic syndrome Elevated blood glucose levels/diabetes Elevated total cholesterol Alcohol and smoking
For primary hypertension, what are some risk factors to children and adolescents? What seems to reduce these risks?
Maternal smoking
Pregnancy induced hypertension
Dietary habits
Low birth rate followed by rapid growth in both height and weight
Lower socioeconomic level of mother
Inadequate intake of calcium by pregnant mother
Breastfeeding seems to reduce risks
Sometimes called the “silent killer” as damage has already occurred to organs before diagnosis is made
Primary Hypertension
In primary hypertension, outcomes include ______ damage
end organ
_____ failure, ____, heart disease outcomes of primary hypertension
renal, stroke
Damage to _____system and acceleration of ______lead to cardiovascular disease in primary hypertension
arterial; atherosclerosis
Increased myocardial work results in heart failure
in ________ hypertension
primary
Glomerular damage results in kidney failure in ______ hypertension
primary
Primary hypertension affects microcirculation of the _____
eyes
Increased pressure in ____ vasculature can result in hemorrhage in _______ hypertension
cerebral; primary
What is the primary treatment strategy for primary hypertension?
Lifestyle modifications are first and most important prevention and treatment strategy
Name some lifestyle modifications for primary hypertension
Weight loss Exercise DASH diet Alcohol moderation Decreased sodium intake
Drug therapy for hypertension affects ____ rate, ____, and/or stroke volume
heart, SVR
In ______ hypertension, it is attributed to a specific identifiable pathology or condition
secondary
Most common form of ______ hypertension is in infants and preschool children
secondary
Most common cause for childhood secondary hypertension is ______
renal disease and coarctation of the aorta
obstructive sleep apnea is another cause of ______ hypertension in children
secondary
Adult secondary hypertension may be related to
_______stenosis
renal artery
Pheochromocytoma
Pregnancy
Obesity/obstructive sleep apnea
may be related to adult _________ hypertension
secondary
The most common cause of secondary hypertension
Hyperaldosteronism
Called hypertensive crisis or malignant hypertension (old term)
hypertensive emergency
sudden increase in either or both systolic or diastolic blood pressure with evidence of end-organ damage
hypertensive emergency
Treating a hypertensive emergency includes rapid but controlled reduction of blood pressure using _______agents under close monitoring (typically in ICU setting)
parenteral antihypertensive
Similar blood pressure elevation to hypertensive emergency without evidence of end-organ damage
hypertensive urgency
How do you treat hypertensive urgency?
Oral medications to bring blood pressure under control over 24-48 hours
An extreme response to the change from supine to upright position; activation of the short-term control mechanisms is slow or inadequate
Orthostatic (postural) hypotension
Causes a decrease in systolic blood pressure (>20 mm Hg or >10 mm Hg within 3 minutes) when moving to an upright position
Orthostatic Hypotension
Excessive increase in heart rate (by _____ to ____beats/minute) may also be diagnostic of orthostatic hypotension
20-30
Results in dizziness, blurred vision, confusion, and possible syncope
Orthostatic hypotension
Orthostatic hypotension is associated with _______disease and is a risk factor for _____, cognitive impairment, and death
cardiovascular; stroke
Orthostatic hypotension is a problem with vasomotor or ______ response
baroreceptor
Orthostatic hypotension may be a result of adverse effect of _____therapy, ______stiffness, _____ depletion
drug; arterial; volume
Orthostatic hypotension is a ______disease process, ________reaction, and _______dysrhythmias
secondary; vasovagal; cardiac
Treatment for orthostatic hypotension includes reviewing medication history, slow ______changes
Avoid _____environments, and
Avoid large or _____-heavy meals
positional; hot; carb
When symptoms begin, squatting/bending forward or crossing legs may reduce effects
orthostatic hypotension
Elastic compression stockings, abdominal binders, elevate head of bed used for ________
orthostatic hypotension
Increase salt and fluid intake if not contraindicated for _______
orthostatic hypotension
