Hypotension, Hypertension Flashcards
If sudden drop in blood pressure it can cause
Syncope
Sudden drop of __ systolic and __ diastolic can cause hypotension
20 mm hg systolic
10mm hg diastolic
Hypotension management
-elevate chair 20 degrees
-late morning/afternoon appts
-slow chair movement to avoid orthostatic hypotension
-if syncope : put in supine position
Significant risk factor for cardiovascular and renal disease
Hypertension
Mechanisms in control for blood pressure
1- neural baroreflexes
2- renin-angiotensin-aldosterone pressor system
3-locally active hormones and inflammatory mediators
Physiologic factors affecting blood pressure
-Polycythemia
-Anemia, Hemorrhage
-Increase in CO by exercise, fever, thyrotoxicosis
BP over ______ are considered at increased risk of cardiovascular disease
115/75 mm hg
White coat hypertension
20% pts with untreated stage 1 hypertension, increase in BP only in the presence of health care worker
How to detect white coat hypertension
24 hour ambulatory monitoring, if otherwise normal- lower risk for hypertensive complications
Pre-Hypertensive
120-129 mm hg & <80mm hg
Stage 1 hypertension
130-139 mm hg , 80-89 mm hg
Stage 2 hypertension
> =140 mm hg, >= 90 mm hg
Most important modifiable risk factor in hypertension
Smoking
Management of hypertensive pt
-Take BP pre op and 5 mins post anesthetic
-anxiolytic and sedatives
-avoid long stressful appts: short and morning
-comfortable chair position
-discharge pt slowly
Drug consideration in hypertension
-Avoid erythromycin & clarithromycin
-NSAIDs avoid more than 2 weeks
-minimize epi to 2 carps on 1:100,000
-avoid retraction cord with epi
