Lecture One : Hypertension Flashcards
what is the arterial pressure of systemic circulation called
blood pressure
pressure gradient generates what?
blood flow
which vital organs does bp maintain a constant blood flow to
heart, brain, and kidneys
what components make up arterial pressure
cardiac output x peripheral resistance
what components make up cardiac output
stroke volume x heart rate
what components make up stroke volume
myocardial contractility and size of the vascular compartments
what components make up peripheral resistance
vascular structure and vascular function
what are some intrinsic factors of blood pressure
HR, SV, and peripheral resistance
What are the components involved with peripheral resistance
vessel diameter, vessel length, vessel integrity, and blood viscosity
what are some extrinsic factors of blood pressure
diet, exercise, emotional state, disease, sleep, drugs, alcohol, stress, and obesity
what is the desired systolic bp
90-119
what is the desired diastolic bp
60-79
Chronic elevated blood pressure
hypertension
hypertension readings are usually
140/90 or greater
what affects the risk of developing HTN
age, race, and sex
T/F; CVD risk doubles for every 20/10 increase above 115/75
True
This type of HTN is 95% of cases; no underlying disease
Essential Primary HTN
Essential Primary HTN Etiologic Factors
Age, sex, low birth weight, race/ethnicity, family Hx, smoking, obesity, diabetes, sedentary lifestyle, suboptimal diet, etc
What are the etiologies of Essential Primary HTN
autonomic system ( homeostatic recalibration ), renin-angiotensin - aldosterone system ( association with obesity ), Reactive oxygen species ( elevated vascular tone) , genetic predisposition ( multifactorial: renal salt handling )
This is a type of HTN where the etiology can be identified ; 5-10 % of cases; assoc with Pheochromocytoma ( adrenal tumor that secretes vasoconstrictive hormones )
secondary HTN
what causes HTN in 5 % of users of high dose HC
hormonal contraceptives and HTN
risk factors for HTN in women
overweight, history of HTN in pregnancy, predisposing condition, family Hx, cigarettes
in what trimester can HTN develop
third trimester
what is white coat HTN
increase up to 20/10 above pts normal BP ( may not be benign )
What is the goal BP for HTN Tx pts
140/90 or less
what are some tx meds for HTN
thiazide diuretics, B-blocker, Ca antagonist, ACE inhibitor, Angiotensin II blocker, and Adrenergic inhibitors
What is a hypertensive urgency
BP of >180/110 , no end organ damage; symptoms would be severe HA, shortness of breath, nosebleeds, severe anxiety
What is a hypertensive emergency
BP > 180/110, end organ damage ; chest pain, shortness of breath, back pain, numbness/.weakness/ changes in vision, trouble speaking ; immediate hospitalization ; potential complications are stroke and pulmonary edema
what is a target organ for HTN that’s important
retina
what is the most common ocular manifestation of HTN
Hypertensive retinopathy; 50-80% chance of developing it
% increase risk of stroke with mild HTN ret
35%
% increase risk of stroke with moderate/ severe HTN ret.
137%
symptoms of hypertensive retinopathy
usually asymptomatic and may have decreased vision
This is a gradual reduction of blood flow to the retina
hypertensive retinopathy
this is a term that rep. swollen axons with intracytoplasmic bodies and rep. hypertensive retinopathy
cotton wool spots
changes such as A/V crossing changes, cotton wool spots, and hemorrhages comes with what type of retinopathy
chronic hypertensive retinopathy
these changes such as retina edema, cotton wool spots, and macular star are what type of retinopathy
acute ( malignant) hypertensive retinopathy
