COW Flashcards
(36 cards)
What is the ratio of people with HTN?
1/3
What is normal blood pressure?
less than 120 sys and less than 80 diastolic
What is Prehypertenstion BP range?
120-139/ 80-89
What is Stage 1 hypertension BP range?
140-159/ 90-99
What is Stage 2 hypertension BP range;
> 160 systolic / > 100 diastolic
What is Isolated systolic BP range
> 140 systolic normal diastolic
(blank) occurs when the blood pressure is greater than 180 systolic or greater than 120 diastolic causing organ dysfunction. (blank) is also known as hypertensive crisis.
Hypertensive emergency
What is the most common reason for pnts to have an appointment with a physician?
htn
(blank) occurs when a patient presents with severely high blood pressure without evidence of organ dysfunction. Greater than 180 systolic, and greater than 110 diastolic.
Hypertensive urgency
What does the RAAS system do?
raises blood pressure due to increasd blood volume and vasoconstriction
If you have diabetes, what do you want your BP to be?
below 130 systolic, below 80 diastolic
Unliateral renal artery stenosis (aka Goldblatt kidney) causes (blank) in the kidney.
ischemia.This ischemia is interpreted as low blood pressure and causes secretion of renin, activating the renin-angiotensin-aldosterone system thereby increasing blood pressure. In bilateral renal artery stenosis renin secretion decreases within 5-10 days and the kidney’s deteriorate and renal failure occurs. Renal failure leads systemic and pulmonary hypertension and edema.
If you block RAAS what happens?
get vasodilation, lower BP and reduced blood volume
What are the main pathophysioloic causes of renal artery stenosis?
The main pathophysiologic causes of renal artery stenosis include; high cholesterol, atherosclerosis, high blood pressure, diabetes, and fibromuscular dysplasia. Fibromuscular dysplasia is normally seen in women under 50. However, high cholesterol, high blood pressure and diabetes are seen in a large age range of people, although, most cases occur in patients around the age of 50.
What is resistant hypertenstion?
resistant to treatments so stays high despite treatment. (make sure it is this and not poor compliance)
What is malignant hypertension?
Rapidly progressive end organ damage, LVH
What do ace inhibitors do : )?
a. Ace inhibitors will block the conversion of angiotensin I to angiotensin II, without the effect of angiotensin II blood pressure will decrease because Na excretion will be maintained with the lack of aldosterone activity decreasing blood volume. In addition, without ACE, bradykinin is expressed and lead to vasodilation and thus decreased blood pressure.
b. Beta blockers will decrease contractility via beta 1 receptors and therefore reduce heart rate and pressure.
c. reduced renin release
Do you treat patients with very high blood pressure if they do not present with symptoms?
NO!
What is primary htn (95% of people have this)
unknown etiology
What is secondary htn?
known etiology (renal parenchymal disease etc)
What are some ways to identify Renal Artery Stenosis?
Duplex ultrasonography
o Pros: can determine the amount of occlusion; can rule out aneurysmal disease and thrombic events; inexpensive
o Cons: can be more time consuming than other lower extremity arterial studies
• Computed tomographic angiography (indicated for patients with normal renal function)
o Pros: option for detection of RAS
o Cons: a negative result does not rule it out
• Magnetic resonance angiography
o Pros: Diagnostic performance is >50% in detecting Renal Artery stenosis, provides information that cannot be obtained by ultrasound or tomographic scans.
• Cons: Gadollinium’s associated with risk of nephrogenic sclerosing fibrosis in people with renal insufficiency
What is doxazosin?
alpha blocker
What does a Loud bruit audible in left flank, S4 Gallop, and PMI laterally displaced indicate?
left ventricular hypertrophy
(blank) plays a huge factor in hypertension/
inflammation
