Overview of Hypertension

Question 1

Single most preventable cause of premature death in developed countries

Answer 1

HBP

Question 2

What is BP?

Answer 2

Force of blood pushing against the walls of arteries as it flows throgu hthem

Varies with physical and mental stress

Question 3

Basic physiology

Answer 3

MAP=CO*TPR

Cardiac output
Total peripheral vascular resistance

Question 4

Patho mech of HTN

Answer 4

Kidney - ability ot sec Na load, RAA axis, renal hemodynamics

BVs - central or local symp NS, vasoactive subs - AT2, PGS< NO

Heart - increased CO

Question 5

PreHTN
Stage 1
Stage 2

Answer 5

120-130/80-89
140-159/90-99
over160/over100

Question 6

Primary HTN

Answer 6

Age, obesity, FH, race

Alcohol, sodium intake

Reduced nephron nuber (premature babies)

Diabetes/dyslipidemia

Integration of genetic factors with the environment

Question 7

Rx HTN as CV risk factor

Answer 7

In order to reduce overall CV risk and preventing morbidity/mortality from CVD…must tx in the context of the individual patient

Question 8

Benefits of tx of HTN

Answer 8

Reduction of stroke incidence, MI, and HF…most in HF

Question 9

Approahc to pt with HTN

Answer 9

Assess presence of absence of target organ damage

Assess presence or absence of other CV risk factors

ID secondary HTN

Question 10

Sx of HTN

Answer 10

Asx except in extremes or after CV comps developed

Headahce may be seen in awakening and occipital in nature

Question 11

PE of HTN

Answer 11

Fundoscopic exam for arteriolar narrowing, AV compression, hemorrhages, exudates, papilledema

Complete cardiac and peripheral pulse…compare radial and femoral pulses

Abdominal exam for masses and bruits…listen high in the flanks over the kidneys

Question 12

Dx studies of HTN

Answer 12

Hb, Hct or CBC
Urinalysis (proteinuria)
K, Ca, Cr
Cholesterol
Fasting glucose
Uric acid 
EKG and chest X-ray