12.7 B

Question 1

What are the criteria for hypertension?

Answer 1

diastolic above 90, systolic above 140

Question 2

What is primary hypertension?

Answer 2

hypertension in which the underlying cause is unknown

Question 3

What is secondary hypertension?

Answer 3

hypertension in which the underlying cause is known

Question 4

What are three theories behind the cause of primary hypertension?

Answer 4

• abnormal functioning of the Na/K ATPase causing elevated cytosolic calcium levels
• decreased levels of NO
• increased levels of endothelin-1

Question 5

How does age affect the reason for hypertension?

Answer 5

• younger people more affected by increased CO

- older people more affected by increased TPR

Question 6

Older people often suffer from hypertension because of what increase compared to younger people?

Answer 6

an increase in TPR

Question 7

Why as people age does TPR become increasingly responsible for essential hypertension?

Answer 7

• arterioles hypertrophy in response to high BP, reduce diameter and increasing contractile force
• decreased ventricular compliance due to ventricular hypertrophy impairs diastolic filling

Question 8

Secondary hypertension is most often the result of what three underlying conditions?

Answer 8

• renal parenchymal disease
• renovascular disease
• pheochromocytoma

Question 9

How does renal parenchymal disease lead to hypertension?

Answer 9

• nephron damage
• impaired renal excretion of sodium and water
• increased blood volume, preload, SV, and CO

Question 10

How does renovascular hypertension lead to systemic hypertension?

Answer 10

• plaques in renal arteries impair blood flow
• renin secretion is increased
• angiotensin II formation increases
• ANG2 causes arteriolar and venous constriction as well as increased aldosterone secretion (which increases blood volume)

Question 11

Renovascular hypertension is due to increases in (CO/TPR).

Answer 11

both, arteriolar constriction increases TPR while venous constriction and aldosterone increase CO

Question 12

How does pheochromocytoma lead to hypertension?

Answer 12

• tumor in adrenal medulla secretes epi and NE

- triggers arteriolar constriction, venous constriction, increased inotropic state, and increased HR

Question 13

How does primary hyperaldosteronism lead to hypertension?

Answer 13

• adrenal gland tumor causes increased plasma aldosterone

Question 14

In addition to hypertension, hyperaldosteronism causes what?

Answer 14

potassium secretion and therefore skeletal muscle weakness

Question 15

What is baroreceptor desensitivity?

Answer 15

the idea that the baroreflex gets desensitized to chronic increases in hypertension and doesn’t respond as strongly to increased MAP

Question 16

How can we tell the difference, clinically, between systolic dysfunction and diastolic dysfunction that both present as heart failure?

Answer 16

systolic dysfunction will present with a reduced ejection fraction while diastolic does not

Question 17

How does hypertension increase the risk of MI?

Answer 17

by leading to ventricular hypertrophy and increasing the oxygen needs of the heart

Question 18

How does hypertension cause arterial damage?

Answer 18

• hypertension leads to endothelial dysfunction, which then leads to thrombus formation and possibly stroke
• it may also physically rupture a vessel

Question 19

What are the four best lifestyle changes to make that will reduce the risk of hypertension?

Answer 19

• decrease body weight
• reduce salt intake
• exercise
• reduce alcohol consumption and tobacco use

Question 20

Beta blockers do what to cardiac function?

Answer 20

decrease heart rate and inotropic state

Question 21

How do ACE inhibitors and angiotensin reduce CO?

Answer 21

through venodilation which will reduce venous return and CO

Question 22

CCBs have what four effects?

Answer 22

• arterial dilation
• venous dilation
• decreased inotropic state
• decreased HR