Hypertension treatment Flashcards

1
Q

What is blood pressure?

A

→ Pressure exerted by blood on blood vessels

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2
Q

What does short term regulation of blood pressure involve?

A

→ baroreceptors

→ Sympathetic and parasympathetic outflow

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3
Q

What does long term regulation of blood pressure involve?

A

→ Hormonal control of total body Na+
→ Control of blood volume via ECFV
→ Degree of vasoconstriction

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4
Q

What is the criteria for hypertension?

A

→ 140/90 mmHg

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5
Q

What is hypertension a risk factor for?

A
→ Stroke
→ Ischaemic heart disease
→ Left ventricular hypertrophy and heart failure
→ renal failure
→ retinopathy
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6
Q

What are secondary causes of hypertension?

A

→ Renal
→ Vascular - renal artery stenosis
→ Hormonal - Conns, Cushings
→ Monogenic genetic diseases - Liddles

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7
Q

What is a primary cause of hypertension?

A

→ Genetic pre disposition and environmental factors

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8
Q

What are 3 possible mechanisms for essential hypertension?

A

→ Increased sympathetic nervous system
→ Increased RAAS
→ endothelial dysfunction

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9
Q

What are 2 possible defects in essential hypertension?

A

→ Vascular smooth muscle contraction

→ Na+ handling and excessive salt intake

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10
Q

What are 4 risk factors for essential hypertension?

A

→ Obesity
→ Age
→ Ethnicity
→ Family history

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11
Q

What does the treatment of hypertension reduce the risk of and by how much?

A

→ Strokes by 42%
→ Heart attacks by 16%
→ Vascular mortality by 21%

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12
Q

What are the goals of anti-hypertensive treatment?

A

→ Adequate blood pressure control
→ Prevention of target organ damage
→ Controlling other cardiovascular risk factors

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13
Q

What are the treatment pathways for hypertension?

A

→ Non-pharmacological
→ Pharmacological treatment
→ Surgical

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14
Q

What are 6 lifestyle changes to prevent hypertension?

A
→ Quit smoking
→ Weight control
→ Eating less salt
→ Regular exercise
→ Reduce alcohol intake 
→ Behavioral therapy
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15
Q

What are 5 major classes of anti hypertensive drugs?

A
→ ACE inhibitors
→ Angiotensin II receptor blockers
→ Diuretics 
→ Drugs acting on sympathetic nervous system 
→ Vasodilators
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16
Q

What are 3 side effects from ACE inhibitors?

A

→ Cough - due to decrease in bradykinin breakdown
→ Angioedema
→ Hyperkalaemia

17
Q

What do diuretics do?

A

→ Increase in Na+ and water excretion
→ Reduce blood volume
→ reduce BP and CO

18
Q

Why do ACE inhibitors causes hyperkalaemia?

A

→ Reduced aldosterone
→ Decreased Na+ reabsorption
→ Decreased K+ excretion

19
Q

What do Beta 1 receptors do?

A

→ Increase HR and contractilityn
→ Increase CO
→ Increase BP

20
Q

What do alpha 1 receptors do?

A

→ vasoconstriction
→ TPR
→ Increased BP

21
Q

What do beta blockers cause?

A

→ Reduction in CO and renin release

22
Q

How do K+ channel openers work?

A
→ K+ channels open 
→ K+ efflux 
→ Hyperpolarization
→ Reduced VGCC activity
→ Reduced intracellular Ca2+ 
→ Less MLCK activity + increased relaxation
23
Q

How do Ca2+ channel blockers work?

A

→ Block VGCC activity in smooth muscle cells
→ reduced intra cellular Ca2+
→ Less MLCK activity + increased relaxation

24
Q

What are issues to take into consideration when treating hypertension?

A
→ Evidence of efficacy
→ Side effects
→ Drug interactions 
→ Quality of life 
→ economic considerations