Systemic Hypertension Flashcards
Why does the LA enlarge in the setting of longstanding HTN?
Due to increased filling pressures and DDFXN
What complications in the heart can arise from HTN?
LVH, IHD/CAD/MI, arrhythmias, CHF
What is secondary HTN?
Due to underlying disease
What is the mean arterial pressure equation?
mAP = CO x SVR
What is the pulse pressure of the following blood pressure:
BP = 160/98
62 mmHg
160 - 98 = 62
The pulse pressure is the difference between the systolic and diastolic BPs
What increases CO?
Increase in SV, HR, preload, blood volume
What causes an increase in SVR?
Vascular structure or function changes like caffeine, nicotine, stress, alcohol, sedentary lifestyle
How is compliance related to pulse pressure?
A stiffer vessel has a higher PP while a compliant vessel has a lower PP
A patient with increased LV RWT but normal LV mass index would have which type of geometric remodeling?
Concentric remodelling
What are 4 risk factors for essential HTN?
Older age, being male, ethnicity, lifestyle factors (smoking, stress, alcohol, etc)
How does HTN affect the LA?
Increases the dimension
True or false. Many aspects of hypertension are lifestyle related
True
What is the relative wall thickness formula and what is normal?
RWT = 2PWd/LVIDd Normal = <0.42
What is considered HTN?
High BP in 2 readings greater than 140/90
What is the diastolic/systolic equation for mAP?
mAP= [(2xdiastolic) + si=systolic]/3
What are some causes of secondary HTN?
Renal disease, endocrine/hormonal disease, vascular disease, CNS increase
What 4 drugs help control HTN?
Diuretics (lower blood volume), beta blockers (lower HR), calcium channel blockers (lower afterload), ACE inhibitors (lower afterload)
What will increase mAP?
Anything that increase CO or SVR such as BP
What 5 pathologies are associated with HTN?
MAC, AV sclerosis, dilated ascending aorta, AI, atherosclerosis of the aorta
Why does blood pressure usually drop a few minutes post exercise compared to pre exercise?
There is vasodilation post exercise
What are 4 metabolic causes of essential (primary) HTN?
High cholesterol, obesity, diabetes, sedentary lifestyle
What does HTN do to the geometry of the LV?
Causes concentric remodelling
What is the only cardiac cause of HTN?
Coarctation of the aorta
What is the LV mass index equation?
LV Mass / BSA
How much of the cardiac cycle is systole and diastole?
Systole is 1/3 and diastole is 2/3
What are the two most common structural changes to the heart with longstanding systemic hypertension?
LVH and LA enlargement
