Chapter 32 Hypertension Flashcards Preview

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Flashcards in Chapter 32 Hypertension Deck (66)
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1

Which race has the highest prevalence of hypertension in the world?

African Americans
have a higher incidence of hypertension among women than among men
Have more nocturnal non-dipping BP
results in more severe end-organ damage

2

Which race is least likely to receive hypertension treatment?

Mexican-Americans
Low rate of controlled BP
Low levels of awareness

3

Which sex is more likely to develop hypertension?

Men
BUT
Women on an oral contraceptive are 3x more likely to develop hypertension

4

How do you calculate Blood Pressure?

Cardiac Output x Systemic Vascular resistance = BP

5

What two body systems affect cardiac output?

Cardiac (Heart rate, contractility, conductivity)
Renal Fluid Volume Control (RAA system, natriuretic peptides)

6

What 3 body systems affect vascular resistance

Sympathetic Nervous System (Alpha 1 and 2 that causes vasodilation and Beta 2 that causes vasodilation)
Neurohormonal (vasoconstrictors like angiotensin and norepinephrine)
Local regulation (Vaso- Dilators/constrictors

7

What type of specialized cells in the carotid arteries and arch of aorta sense changes in BP and transmit this info to the brain

Barocreceptors (pressure receptors)

8

What effect does Alpha 1 have on the body?

Vasoconstriction
increased contractility (positive ionotropic)

9

What effect does Alpha 2 have on the body

Inhibits norepinephrine release
vasoconstriction

10

What effect does Beta 1 have on the body

Causes a positive
Inotropic effect (contractility)
Chronotropic (heart rate)
dromotropic effect (conduction)

11

What is a positive and negative
1) inotropic effect
2) chronotropic effect
Dromotropic effect

1) increase or decrease in heart contractility
2) increase or decrease in heart rate
3) increase or decrease in heart conduction

12

What effect does Beta 2 have on the body

Vasodilation

13

What effect does dopamine receptors have on the body

Vasodilation

14

How does the renal system contribute to hypertension?

The kidneys regulate sodium and ECF volume, which dictates total fluid volume of the body
It also regulates the renin-angiotensin-aldosterone system.
Overall the kidneys regulate the amount of sodium and fluid in the body

15

What is are the different stages of hypertension

Normal BP: 100-120 /60-80
Pre-hypertensive: 120-139/ 80-90
Hypertensive Stage 1: 140-159/90-100
Hypertensive Stage 2: >160/>100

16

What is Isolated Systolic Hypertension (ISH)

An average systolic BP of 140 or greater with an average diastolic BP under 90

17

What is Primary Hypertension and what is the patients treatment goal?

Hypertension without an identified cause (it is idiopathic)
There are contributing factors though, such as:
SNS activity, hypernatremic, greater than ideal body weight, tobacco use, too much alcohol

Usually treated by trying to lower the BP by weight loss, lower sodium intake, or antihypertensive meds

18

What is Secondary Hypertension and what is the patients treatment goal?

Elevated BP with a specific cause such as cirrhosis, endocrine disorders, renal disease, NSAIDS, Oral contraceptives, corticosteroids
Treatment at removing the underlying cause

19

What role does the SNS have on BP

Increases HR and hear contractility
controls vasoconstriction and renin release

20

What are some severe symptoms of hypertension?

Fatigue, dizziness, palpitations, angina, dyspnea

21

What is the most common complication of hypertension?

Target organ disease
These include: CAD, Left ventricular hypertrophy, Heart failure, atherosclerosis, nephrosclerosis

22

How does hypertension affect the kidneys?

It causes Ischemia that leads to the narrowing of the renal blood vessels. This causes atrophy of the tubules and the eventual death of the nephrons

23

What labs are analyzed to see if renal disease is occurring?

Albuminuria, proteinuria, elevated serum creatinine and BUN

24

Is the retina important with hypertension?

Yes, it can provide important information about the severity and duration of hypertension
The damage can provide information that can help see if damage is occurring in the heart, brain, and kidneys.

25

What is the overall goal of treatment for a patient who has hypertension

Lower their BP, reduce their cardiovascular risk factors and their risk of target organ disease

26

What is the purpose of an electrocardiogram?

It provides baseline information about heart status
It can identify LVH (if suspected though an echocardiography is performed), Cardiac ischemia, previous MI

27

What is White Coate Hypertension

Elevated BP that occurs in a clinical setting but not in a normal setting

28

When is blood pressure the highest and lowest for a day-active person?

Blood pressure is highest in the morning and decreases during the day to eventually be the lowest at night.
Pt with hypertension sometimes do not experience this nocturnal dip (nondippers)

29

What is a reverse dipper?

This is a patient who has their highest systolic BP at night, they have the highest risk of CVD

30

What are the 7 lifestyle modifications that can be used to help treat hypertension and overall decrease a patients cardiovascular risk

1) Weight reduction
2) Dietary Approaches to Stop Hypertension eating plan(DASH)
3) Reducing dietary sodium
4) Moderating alcohol intake
5) getting regular exercise for at least 30 min most days of the week (about 5)
6) avoiding tobacco
7) managing psychosocial risk factors