hypertension (flex week) Flashcards
blood pressure equation
ABP = COxTPR (total peripheral resistance)
sepsis and blood pressure?
sepsis can lead to systemic vasodilation leading to drop in total peripheral resistance leading to low blood pressure
how does the body manage blood pressure (2 ways)
carotid baroreceptors
renin angiotensin system
renin angiotensin system explanation?
drop in blood pressure -> renin production from kidney -> angiotensin 1 to angiotensin 2 -> vasoconstriction and retention of salt & water -> increased blood pressure
what does kidney failure cause
high blood pressure
why is high blood pressure required in the kidneys
allows glomerular filtration
causes of high blood pressure? (6)
increased cardiac output
sensors confused
kidneys cant excrete salt/water
sympathetics activated
RAAS activated
increase in TPR
causes of high blood pressure - cardiac output increase - examples
exercise
hyperthyroidism
causes of high blood pressure - sensors confused - examples
renal artery stenosis
baroreceptor dysfunction
causes of high blood pressure - kidneys can’t excrete salt/water - examples
advanced CKD
NSAIDs
causes of high blood pressure - sympathetics activated - examples
stress
phaeochromocytoma
sleep apnoea
cocaine
causes of high blood pressure - RAAS - examples
hyperaldosteronism
Cushing syndrome
iatrogenic glucocorticoids
causes of high blood pressure - increase in TPR - examples
coarctation
hypertension definition
blood pressure high enough to cause disease: >140/90
consequences of hypertension
stroke
MI
heart failure
atrial fibrillation
kidney failure
retinopathy
encephalopathy
hypertension more common in men or women?
men! (L)
biological causes of hypertension
genes:
-salt excretion
-drug metabolism
-target organ damage
social causes of hypertension
diet
economic status
education
engagement with healthcare
psychological causes of hypertension
stress
depression
hypertension treatment - lifestyle
low sodium chloride intake
high potassium intake (fresh fruit & veg)
drink less alcohol
physical activity
weight loss
hypertension treatment - procedures
NOT STANDARD PRACTICE:
sympathetic denervation
carotid baroreceptor stimulation
AV fistula formation
hypertension treatment - drugs
calcium channel blockers
ACEi/ARBs
thiazide diuretics
alpha and beta blockers for second line treatment
anti-hypertensive therapies adverse effects
all cause dizziness, falls
vasodilators can cause ankle oedema
diuretics cause gout, hyponatraemia, hypokalaemia
what factors affect what type of hypertension treatment to give
CCB to those aged over 55 and black African/African Caribbean (can’t have ACEi/ARB)
ACEi/ARB to those with diabetes mellitus (can’t have CCB)
