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Pathophysiology - Midterm > Lecture 3: Hypertension > Flashcards

Lecture 3: Hypertension Flashcards

1
Q

When a blood pressure is indicated as 120/80, what does each number represent?

A
  • Top number is systolic, which is the pressure during contraction
  • Bottom number is diastolic, which is the pressure during rest/filling
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2
Q

What is mean arterial pressure?

A

The average pressure throughout the entire cardiac cycle

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3
Q

How much of the mean arterial pressure if diastole and how much is systole?

A

2/3 diastole and 1/3 systole

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4
Q

What does mean arterial pressure determine?

A

If organs are being perfused

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5
Q

What is the equation for blood pressure?

A

BP = TPR (total peripheral resistance) x CO (cardiac output)

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6
Q

What is the equation for cardiac output?

A

Heart rate (how fast) x stroke volume (how much)

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7
Q

What happens to cardiac output and blood pressure when heart rate is increased?

A

They both increase

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8
Q

What is blood pressure?

A

The pressure on arterial walls

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9
Q

What are the “big 5” BP mechanisms?

A

1) RAAS
2) Electrolytes
3) Neuronal signals
4) Vascular
5) Hormonal

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10
Q

What happens in the RAAS?

A
  • Juxtaglomerular cells secrete renin, which converts angiotensinogen to angiotensin 1
  • ACE (angiotensin-converting enzyme) converts angiotensin 1 to angiotensin 2
  • Angiotensin 2 has a number of effects
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11
Q

What is the main effect of angiotensin 2?

A

Increased blood pressure

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12
Q

What 6 organs/systems does angiotensin 2 affect?

A
  • Adrenal cortex
  • Kidney and intestine
  • Central nervous system
  • Peripheral nervous system
  • Vascular smooth muscle
  • Heart
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13
Q

What affect does angiotensin 2 have on the adrenal cortex?

A

1) Increases aldosterone synthesis
2) Sodium/water reabsorption
3) Increased blood volume
4) Increased TPR
5) Increased blood pressure

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14
Q

What affect does angiotensin 2 have on the kidneys and intestine?

A

1) Sodium/water reabsorption
2) Increased blood volume
3) Increased TPR
4) Increased BP

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15
Q

What affect does angiotensin 2 have on the CNS?

A

1) ADH/vasopressin release or sympathetic discharge
2) Increased blood volume
3) Increased TPR
4) Increased BP

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16
Q

What affect does angiotensin 2 have on the PNS?

A

1) Sympathetic discharge (vasoconstriction)
2) Increased TPR
3) Increased BP

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17
Q

What affect does angiotensin 2 have on vascular smooth muscle?

A

1) Vasoconstriction
2) Increased TPR
3) Increased BP

18
Q

What affect does angiotensin 2 have on the heart?

A

1) Increased force of contractility
2) Increased CO
3) Increased BP

19
Q

What effect do electrolytes have on BP?

A

1) Increased sodium = increased water

2) Decreased potassium and decreased calcium can potentially increase PVR

20
Q

What effect do neuronal/brain signals have on BP?

A

Sympathetic and parasympathetic produce:

1) Higher order reflexes (mood/emotion)
2) Intrinsic reflexes – inside circulatory system (chemo/baroreceptors)
3) Extrinsic reflexes – outside circulatory system (pain/cold)

21
Q

What are baroreceptors?

A
  • Pressure receptors

- Ex: juxtaglomerular cells

22
Q

What 3 hormones in the body cause vasoconstriction?

A
  • Angiotensin 2
  • Vasopressin
  • Endothelin
23
Q

What 3 substances cause vasodilation?

A
  • Prostacyclin
  • Nitric oxide
  • Bradykinin
24
Q

What are natriuretic hormones?

A

Hormones that shut down the Na/K pump, leading to vasoconstriction

25
Q

What are the 5 classifications of BP?

A
  • Normal
  • Prehypertension
  • Stage 1
  • Stage 2
  • Hypertensive crisis
26
Q

What is a normal BP?

A
  • SBP = less than 120

- DBP = less than 80

27
Q

What is a prehypertension BP?

A
  • SBP = 120-139

- DBP = 80-89

28
Q

What BP fits stage 1 hypertension?

A
  • SBP = 140-159

- DBP = 90-99

29
Q

What BP fits stage 2 hypertension?

A
  • SBP = 160-179

- DBP = 100-109

30
Q

What BP is considered a hypertensive crisis?

A
  • SBP over 180

- DBP over 110

31
Q

What are the risk factors for hypertension?

A
  • Similar to heart disease

- Age, obesity, race

32
Q

What is essential hypertension?

A
  • No idea of the cause

- Over 90% of cases

33
Q

What is secondary hypertension?

A

Known cause, normal a disease or drug

34
Q

What are symptoms of hypertension?

A
  • No symptoms (“silent killer”)

- Sometimes headaches or blurred vision

35
Q

What affect can untreated hypertension have on the heart?

A
  • Coronary artery disease

- Heart failure

36
Q

What affect can untreated hypertension have on the brain?

A

Stroke

37
Q

What affect can untreated hypertension have on the kidney?

A

Glomerulus can burst

38
Q

What affect can untreated hypertension have on the eyes?

A
  • Retinopathy

- Burst blood vessels

39
Q

What affect can untreated hypertension have on the vessels?

A
  • Varicose veins

- Reduced sensitivity in the extremities

40
Q

What 5 lifestyle modification should be made to someone with hypertension?

A
  • Decreased weight
  • Decreased sodium
  • Physical activity
  • DASH diet
  • Less alcohol

Pathophysiology - Midterm (11 decks)

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