CVS 5 Control Of Blood Presure+ Hypertension Flashcards
Hypertension definition
Sustained increase in blood pressure
Normal range of blood pressure
Systolic - 90-120
Diastolic - 60-80
Normal systolic range of BP
90-120
Normal diastolic range of BP
60-80
BP in stage 1 hypertension
> 140/90 mmHg
BP in stage 2 hypertension
160/100 mmHg
BP in severe hypertension
> 180 systolic or > 110 diastolic
Difference in the changes of the stages of hypertension
+ 20 systolic: - normal 90-120
- stage 1 140
- stage 2 160
- severe 180
+ 10 diastolic: - normal 60-80
- stage 1 90
- stage 2 100
- severe 110
Causes of primary hypertension
Idiopathic - Unknown
Causes of secondary hypertension
Cause known
Important to identify + treat underlying cause
e.g. chronic renal disease, Cushing’s syndrome, hyperaldosteronism
Why is hypertension called the silent killer?
Asymptotic
But has damaging effects on heart + vasculature
e.g. MI, stroke, renal failure
What organs should be assessed by clinical history + physical exam in relation to hypertension?
Brain
Eyes
Heart
Kidneys
Arteries
What controls short term regulation of blood pressure?
Baroreceptors reflexes
Why can baroreceptors only work in short term regulation of BP?
Threshold for baroreceptor firing resets
So not long term
Where are baroreceptors located?
Carotid sinus
Aortic arch
What controls long term regulation of blood pressure?
Neurohoromal response
Control of Na+ balance - Na+ leaves + water follows
Decrease in SV = decrease in CO = decrease in BP
What are the neurohumoral pathways that control blood pressure?
1- renin-angiotensin-aldosterone-system
2- sympathetic nervous system
3- anti diuretic hormone
4- atrial natriuretic peptide
Where is renin released from?
Granular cells of juxaglomerular apparatus (JGA) in kidney
What is renin release stimulated by?
- decreased NaCl delivery to distal convoluted tubule
- decreased kidney perfusion
- sympathetic stimulation of JGA
What is kidney perfusion detected by?
Baroreceptors in afferent arteriole to kidney
What can a decrease in kidney perfusion be due to?
Renal artery stenosis
Decrease circulating volume
What is the pathway in RAAS?
Angiotensinogen > angiotensin I > angiotensin II
renin. ACE
What is angiotensinogen produced by?
Liver