Intro Flashcards
Most common chronic disease in Kentucky
hypertension
What is hypertension?
An elevation in systolic and/or diastolic blood pressure, relative to normal for patient.
What BP reading is generally classified as hypertension?
SBP > 140 and/or DBP > 90
Isolated systolic hypertension (ISH) is most common in who?
Those over 60 years
What BP reading is hypertensive crisis?
DBP > 110
About what % of HTN cases are primary?
90%
What is the cause of primary hypertension?
unknown (idiopathic)
What groups typically have low renin HTN?
African Americans and elderly
What are some drugs used to treat moderate/high renin HTN?
ACEi, ARB, diuretic
What are some drugs used to treat low renin HTN?
diuretics, CCB, BB
What BP reading does JNC8 recommend starting pharmacological therapy?
140/90
> 60 yo: BP > 150/90
Secondary HTN can be caused by
renovascular disease aortic narrowing Primary aldosteronism hyperadrenalism hyperthyroidism pregnancy medication
What are 4 mechanisms by which you can increase BP?
increase fluid intake
decrease fluid output
constrict vessels
increase cardiac output
What is the immediate acting natural regulator of BP?
baroreceptor reflex
What is the intermediate acting natural regulator of BP?
circulating vasoactive substances (epinephrine
What is the long-term natural regulator of BP?
Renin, Angiotensin, Aldosterone System
What is the single mechanism by which the body ultimately controls BP?
aldosterone : kidneys: fluid volume
Where is renin released?
granular cells of JGA
HTN is suspected to be a result of what underlying chronic disease?
renal failure
Vasodilatory therapy always includes what?
diuretic
What is the purpose of removal/ablation of efferent or afferent arterioles?
decreases sympathetic outflow and thus decreases renin release
Variants of what enzyme is thought to be a genetic contributor of HTN?
STK39
In whom was the enzyme associated with HTN identified?
Old Order Amish population
In the case of the mutated enzyme associated with HTN, is polymorphism a result of elevated or decreased expression?
elevated STK39
