S2 L1.1: Systemic Arterial Hypertension Flashcards
T/F: Hypertension always refer to high blood
pressure
False
Systemic arterial hypertension refers tp high blood pressure, most specifically to the pressure inside the artery.
Systemic Arterial Hypertension is a major risk factor for __ __ __
Atherosclerotic Cardiovascular Disease
Process by which we form and deposit cholesterol plaques in arterial walls
Atherosclerosis
To measure the presence of coronary atherosclerosis, MD use methods for detecting coronary calcium because?
Atherosclerotic plaques become progressively calcified over time, and coronary calcification in general increases with age.
T/F:Many patients with hypertension are NOT diagnosed
True.
A lot of individuals c HTN are asymptomatic (Feel nothing but BP can range from 150-200)
T/F: Decreased BP remains a major contributor of CAD, CHF, CVD and ESRD
False
High or increased BP
Process of kidney failure where it ends with dialysis/kidney transplant
End Stage Renal Disease
T/F: High BP deccelerates atherogenesis and and increases the risk of cardiovascular events
False
High BP accelerated atherogenesis
Cardiovascular Events in SBP/DBP
Normal DBP, elevated SBP OR Normal SBP, elevated DBP
Associated with a lot of cardiovascular events
CVA (strokes, etc.), myocardial infarction, and heart failure/attacks
Cardiovascular Events in SBP/DBP
Elevated SBP (more elevated than DBP)
Develop strokes more than heart attacks
Cardiovascular Events in SBP/DBP
Elevated DBP
Pushes the patient more towards heart attacks or myocardial infarction
Cardiovascular Events in SBP/DBP
Both elevated SBP & DBP
Lead to more CV events
T/F:Hypertension occurs in association (not always alone) with other atherogenic factors including dyslipidema, glucose tolerance, hyperinsulinemia, and obesity.
False
Glucose Intolerance
Abnormal levels in lipid levels (high bad cholesterol, low good cholesterol, high triglycerides)
Dyslipidemia
T/F: Htn and dyslipidemia frequently occur together and in association with resistance to insulin-stimulated glucose uptake.
True
Range from pre-diabetes to diabetes
Glucose Intolerance
Atherogenic factor related to glucose intolerance
Hyperinsulinemia
T/F: Association of hypertension with other risk factors is additive rather
than multiplicative
False.
Multiplicative rather
than additive
Statement 1: CAD is approximately twice as prevalent in hypertensives as in normotensive person of same age
Statement 2: Presence of CAD in patients with SAH would be twice more when you compare them to those whom do not have hypertension
a. TF
b. FT
c. TT
d. FF
c. TT
Is this a factor that contribute to the increase risk of CHD (If yes why)?
Coronary arteriolar hypertrophy
Yes.
Hypertrophy of arteriolar vessels of the heart
Is this a factor that contribute to the increase risk of CHD (If yes why)?
Accelerated enlargement of epicardial arteries
No. (Accelerated Narrowing)
Epicardial arteries become narrow when Htn is present which is accelerated by increasing BP levels
Is this a factor that contribute to the increase risk of CHD (If yes why)?
Perivascular fibrosis
Yes
Htn promotes inflammation
Fibrosis is the end of inflammation
Is this a factor that contribute to the increase risk of CHD (If yes why)?
Increased myocardial vascularity
No (Reduced)
Less food/blood circulating in heart d/t Htn
This is the major arterial supply of the heart
Epicardial Arteries
Comprised of left main coronary artery which bifurcates into left anterior descending and left anterior circumflex arteries
Left Circulation of Heart
Comprised of right coronary artery
Right Circulation of Heart
T/F: Weaker muscle, less blood supply = lesser risk of CAD d/t Htn
False
Greater Risk
SBP OR DBP
Pressure measured in brachial artery during systole
SBP
SBP OR DBP
Ventricular filling and ventricular relaxation
DBP
SBP OR DBP
Pressure measured in brachial artery during diastole
DBP
SBP OR DBP
Ventricular emptying and ventricular contraction period
SBP
SBP OR DBP
The 1st loudest sound when you release the cuff in BP taking is d/t?
Ventricular emptying
When do you get the DBP when taking someone’s blood pressure?
When the Korotkoff sound disappears
When taking the patient’s blood pressure, the last heard sound you heard was around 90 mmHg. What is the patient’s estimated BP?
It should be 89, 85 or even 80 mmHg
Determinants of Arterial Pressure
Product of cardiac output and the peripheral resistance
Aterial Pressure
Determinants of Arterial Pressure
Product of the stroke volume and heart rate
Cardiac Output
Determinants of Arterial Pressure
Amount of the blood each time the heart pumps
Stroke Volume
Statement 1: The less amount of blood that the heart ejects, the higher would be the stroke volume is
Statement 2: Higher heart rate = the BP would also be higher
a. TF
b. FT
c. TT
d. FF
b. FT
The more amount of blood that the heart ejects, the higher would be the stroke volume is
If you have more fluid in the blood going into the heart circulation → blood pressure could increase
Which will result to?
Hypertension
If less fluid/blood (dehydrated) = less venous return → stroke volume would be reduce → cardiac output would also be reduce = arterial pressure would go down
Which leads to?
Hypotension
If a patient has diarrhea, would you expect BP to go down?
Yes
dehydrated or losing a lot of fluids
What compensatory mechanism does the body do to compensate for a decrease in stroke volume to maintain a normal cardiac output?
Increase the heart rate
When the blood vessels constrict to increase the pressure inside, there will be an increase in what?
Peripheral Resistance
Arterial pressure could also increase
What are the parameters that would affect the compensation of the determinants of arterial pressure?
- Effort to achieve homeostasis
- Happens when the individual has normal physiologic functions
“Average” pressure throughout the cardiac cycle against the walls of the proximal systemic arteries (aorta)
Mean Arterial Pressure
In stroke patients, maintain MAP to preserve __ __
Ischemic penumbra
PSA-PHA GUIDELINES
Normal BP values
<120/80
PSA-PHA GUIDELINES
Borderline BP
120-138 / 80-89
PSA-PHA GUIDELINES
Hypertension
≥140/90
