S2 - Hypertension and Stroke Flashcards
What is primary (essential) hypertension?
For what percentage of HTN cases does it account?
An idiopathic form of HTN (cause unknown)
90%
What is secondary HTN (responsible for 10% of cases)?
HTN due to some underlying disease
What is systolic blood pressure? What is diastolic blood pressure?
Systolic BP = BP while the ventricles are contracting - Top number (e.g. 120 / 80)
Diastolic BP = BP while the ventricles are relaxing - Bottom number (e.g. 120 / 80)
What is the normal blood pressure classification?
< 120 / 80 mmHg
What is the proper classification for an individual with a BP ranging from 120 - 129 / 80 mmHg?
Elevated BP
(No longer known as pre-HTN)
What is the stage 1 HTN pressure reading?
130 to 139 / 80 to 89 mmHg
What is the stage 2 HTN pressure reading?
≥ 140 / ≥ 90 mmHg
At what BP reading is an individual considered to be in a hypertensive crisis (at immediate risk for organ damage)?
≥ 180 / ≥ 120 mmHg
What are some common complications of HTN?
Stroke
Atherosclerosis
Thrombosis
Aneurysm formation
Organ damage
(Not a comprehensive list)
What is the DASH diet?
An antihypertensive diet focusing on the reduction of salt and lipid intake
What lifestyle modifications can be utilized to lower BP?
Weight loss
Salt intake reduction
Physical activity increase
Meditation
What is the REGARDS study?
the REasons for Geographic And Racial Differences in Stroke
Define ischemia
Lack of oxygen delivery to tissues
Define infarct.
Cell damage and death due to loss of blood flow
What is the definition of a transient ischemic attack?
A ‘mini-stroke’ that results in signs and symptoms that have completely resolved 24 hours after the insult
Just as heart attack refers to an acute myocardial infarction, what is the term that can also refer to a cerebral infarction (stroke)?
Cerebrovascular attack (CVA)
What are the two main types of stroke?
Which is more common?
Which is more deadly?
Ischemic (thrombotic; loss of blood supply) and hemorrhagic (rupture leads to blood entering cranial space)
Ischemic is more common (85-90% of cases)
Hemorrhagic is more deadly
What is the core zone of a stroke? What is the ischemic penumbra?
The core zone refers to the infarcted tissues following complete loss of blood supply
The penumbra refers to the affected area of tissue that is often still viable tissue but will die if perfusion is not reestablished; there is usually some collateral circulation supplying the tissues with some blood flow
Define aneurysm.
A weakening or outpouching in the blood vessel wall (a ballooning that is more likely to rupture than surrounding tissue)
What are some of the risk factors for stroke?
Hypertension (Most important factor)
Metabolic syndrome
Atherosclerosis
Atrial fibrillation
Aneurysms
Race (African-Americans more at risk)
Medical history of thrombotic events
What are some of the common signs and symptoms of stroke?
Headache, weakness, paralysis, dizziness, vision changes, balance changes, drooping facial features, slurred speech, disorganized speech or thoughts
(Physical signs often unilateral)
On which side of the body will a right-sided stroke manifest?
What is the term for this manifestation?
The left side (and vice-versa for a left-sided stroke)
Contralateral
How can stroke be diagnosed?
Clinical presentation, MRI, CT scans, angiography
What medication can be given to prevent thrombotic stroke?
What medication can be given to dissolve the clot that is causing thrombotic stroke?
Aspirin and/or heparin
TPA (tissue plasminogen activator)
Where does stroke fall in the U.S. leading causes of death?
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