Hypertension treatment Flashcards
What is blood pressure?
→ Pressure exerted by blood on blood vessels
What does short term regulation of blood pressure involve?
→ baroreceptors
→ Sympathetic and parasympathetic outflow
What does long term regulation of blood pressure involve?
→ Hormonal control of total body Na+
→ Control of blood volume via ECFV
→ Degree of vasoconstriction
What is the criteria for hypertension?
→ 140/90 mmHg
What is hypertension a risk factor for?
→ Stroke → Ischaemic heart disease → Left ventricular hypertrophy and heart failure → renal failure → retinopathy
What are secondary causes of hypertension?
→ Renal
→ Vascular - renal artery stenosis
→ Hormonal - Conns, Cushings
→ Monogenic genetic diseases - Liddles
What is a primary cause of hypertension?
→ Genetic pre disposition and environmental factors
What are 3 possible mechanisms for essential hypertension?
→ Increased sympathetic nervous system
→ Increased RAAS
→ endothelial dysfunction
What are 2 possible defects in essential hypertension?
→ Vascular smooth muscle contraction
→ Na+ handling and excessive salt intake
What are 4 risk factors for essential hypertension?
→ Obesity
→ Age
→ Ethnicity
→ Family history
What does the treatment of hypertension reduce the risk of and by how much?
→ Strokes by 42%
→ Heart attacks by 16%
→ Vascular mortality by 21%
What are the goals of anti-hypertensive treatment?
→ Adequate blood pressure control
→ Prevention of target organ damage
→ Controlling other cardiovascular risk factors
What are the treatment pathways for hypertension?
→ Non-pharmacological
→ Pharmacological treatment
→ Surgical
What are 6 lifestyle changes to prevent hypertension?
→ Quit smoking → Weight control → Eating less salt → Regular exercise → Reduce alcohol intake → Behavioral therapy
What are 5 major classes of anti hypertensive drugs?
→ ACE inhibitors → Angiotensin II receptor blockers → Diuretics → Drugs acting on sympathetic nervous system → Vasodilators