week 4 - hyper tension

Question 1

Factors Influencing Blood Pressure

Answer 1

bp= CO x Systemic Vascular

Resistance

Question 2

hypertension

Answer 2

Hypertension is sustained elevation of BP
Systolic blood pressure  140 mm Hg
Diastolic blood pressure  90 mm Hg

***The exception is the diabetic patient! These parameters define hypertension in this population
SBP >130
DBP>80

Question 3

normal bp

Answer 3

120/80

Question 4

prehypertension

Answer 4

120-139/80-89

Question 5

stage 1 hypertension

Answer 5

140-159/90-99

Question 6

stage 2 hypertension

Answer 6

equal or more than 160/100

Question 7

HIGH BP IS DEFINED AS

PERSISTENT BP OVER

Answer 7

140/90

Elevated readings must be present on at least 3 occasions
over several weeks

Question 8

Primary (Essential) Hypertension

Answer 8

• Elevated BP with no known cause

- 85-90% of all cases

Question 9

Secondary Hypertension

Answer 9

Elevated BP with a specific cause

- Approximately 10% of adults

Question 10

Primary HTN: Risk Factors

Answer 10

**Family Hx of HTN
 Sodium intake
 Excessive alcohol intake
Physical inactivity
Excess calorie intake
Low potassium intake
**age > 60 
Hyperlipidemia
**Ethnicity
Obesity
Smoking
Stress
intake K+, Ca+, Mg+

Question 11

Secondary Hypertension: Risk Factors

Answer 11

• Coarctation of aorta
  * Renal disease
  * Endocrine disorders
  * Neurological disorders

Question 12

HypertensionClinical Manifestations

Answer 12

MAY experience :Dizziness or fainting (syncope)
Headache
Facial flushing
*****Usually asymptomatic until it becomes severe and target organ disease has occurred

Question 13

HypertensionComplications

Answer 13

The common complications are
target organ diseases occurring in the:

Heart
Brain
Kidney
Eyes

Question 14

Hypertensive Heart Disease

Answer 14

Coronary artery disease (CAD)
 Left ventricular hypertrophy (LVH)
 Heart failure (HF)
Cerebrovascular Disease
 -Stroke
 Peripheral Vascular Disease
 Nephrosclerosis
 Retinal Damage

Question 15

• Use arm with higher reading for subsequent measurements

Answer 15

• BP highest in early morning, lowest at night

Describe patient teaching for self-monitoring

Question 16

HypertensionDiagnostic Studies

Answer 16

Routine urinalysis
 Serum electrolytes 
BUN and serum creatinine
 Serum lipid profile
 ECG
**these will identify secondary HTN causes or complications of HTN

Question 17

• “White coat” phenomenon AND

Masked HTN

Answer 17

high bp in clincal settings and high bp in home settings

Question 18

DASH Diet (Dietary Approaches to Stop Hypertension)

Answer 18

2-3 servings of low fat milk, yogurt, cheese for calcium
8-10 helpings of fruit and vegetables (bananas, OJ and spinach for potassium)
2400 mg of sodium or less than 6 mg of table salt a day
diet low in saturated fats and rich in fruits/vegetables and low fat dairy foods
limit alcohol
avoid fast food
weight loss

Question 19

Drug Therapy

Answer 19

ACE (angiotensin converting enzyme) inhibitors
ARBs (angiotensin receptor blockers)
Calcium channel blockers  (CCBs)
Beta Blockers
Diuretics