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BSI 2 > Lecture 24 > Flashcards

Lecture 24 Flashcards

1
Q

Hypertension is defined as systolic or diastolic blood pressure greater than _______

A

140/90

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2
Q

Hypertension by known causes such as NSAIDS, caffeine, ephedrine, etc is known as _______ hypertension.

A

Secondary

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3
Q

T or F? 90-95% of hypertensive patients has primary (essential) hypertension.

A

True

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4
Q

What are some possible mechanistic contributors to essential hypertension?

A

Neuronal Mechanism
Peripheral Autoregulatory Mechanisms
Humoral Factors
Vascular Endothelial Mechanisms

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5
Q

What are the neuronal mechanisms associated with hypertension?

A

Overstimulation of the SNS

Disturbance in the baroreceptor reflex

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6
Q

What are the peripheral autoregulation mechanisms associated with hypertension?

A

Kidneys reset equilibrium point for appropriate blood volume to a higher level which leads to increased blood volume.

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7
Q

What are the humoral factors associated with hypertension?

A
  1. Increased activation of renin-angiotensin-aldosterone system
  2. Insulin resistance and hyperinsulinemia
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8
Q

What can insulin resistance and hyperinsulinemia do to cause hypertension?

A
  1. Can lead to activation of SNS
  2. Can stimulate hypertrophy of vascular smooth muscle which reduces the internal diameter of arterioles and results in an increase in TPR
  3. Can change sodium and calcium transport across cell membranes of vascular smooth muscle, thereby sensitizing arterioles to vasopressor stimuli
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9
Q

What are the vascular endothelial mechanisms associated with hypertension?

A
  1. Deficiency in local vasodilator substances (bradykinin, nitric oxide, etc)
  2. Increased production or release of vasoconstriction substances (endothelin, etc)
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10
Q

What are the risk factors of hypertension?

A
  1. Aging
  2. Excessive salt intake
  3. Race
  4. BMI > 30 (i.e obesity)
  5. Genetic Susceptibility
  6. Insulin resistance and compensatory hyperinsulinemia
  7. Cigarette Smoking
  8. Excessive alcohol
  9. Use of oral contraceptives
  10. Low dietary potassium
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11
Q

Obesity is associated with what factors?

A
  1. Insulin resistance and hyperinsulinemia
  2. Increased fluid volume
  3. Increased stimulation of SNS
  4. Increased stimulation of RAAS
  5. Inflammation
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12
Q

How can cigarette smoking cause hypertension?

A

Nicotine causes discharge of catecholamines.

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13
Q

How can excessive alcohol use cause hypertension?

A

May involve increased plasma catecholamines

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14
Q

How can the use of oral contraceptives cause hypertension?

A

It can stimulate RAAS.

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15
Q

How can a low potassium diet cause hypertension?

A

Potassium consumption increases excretion of sodium, so low potassium consumption will cause more sodium to stay in the body.

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16
Q

What is the natural course of systemic hypertension?

A
  1. Hypertension accelerates atherosclerosis

2. Hypertension causes LEFT ventricular hypertrophy and dysfunction

17
Q

What are the main cause of death in a hypertensive patient?

A 
Stroke
Cardiovascular accidents (Atherosclerosis with resulting myocardial infarction and heart failure)
Renal failure (due to arteriosclerosis in renal arteries)
18
Q

How does ACE-Inhibitors affect MAP?

A

Decrease Ang II production, decreasing TPR and decrease blood volume and CO.

19
Q

How does Angiotensin-II receptor blockers (ARBs) affect MAP?

A

Blocking Ang II receptor decreases TPR and decreases blood volume and CO.

20
Q

How does renin Inhibitors affect MAP?

A

Ang II will decrease therefore decrease TPR and decrease blood volume and CO

21
Q

How does aldosterone antagonists affect MAP?

A

Will decrease retention of water and salt, therefore decrease blood volume and CO.

22
Q

How does beta blocker affect MAP?

A

Blocks norepi from binding to beta receptors, therefore decrease HR and contractility and decrease CO.

23
Q

How does calcium channel blockers affect MAP?

A

Blocks L-type Calcium channels decrease contractility, therefore decrease CO

24
Q

How does diuretics affect MAP?

A

Blocks reabsorption of sodium and water, therefore decreasing blood volume and CO.

25
Q

How does arteriolar vasodilators affect MAP?

A

Dilators directly decrease TPR

BSI 2 (22 decks)

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