HTN- Test 1 Flashcards
Gold standard for recommendations of best clinical practice
JNC8
Desired BP for ages 60 and older
150/90
People under 60
140/90
Control of peripheral vascular resistance
Autonomic nervous system-
Norepinephrine and epinephrine
Four systems maintain blood pressure
Arterial baroreceptors
Fluid volume
Renin-angiotensin-aldosterone system
Vascular autoregulation
Where are arterial baroreceptors found?
Carotid sinus
Aorta
Wall of left ventricle
fluid volume and BP
More fluid= higher pressure
Less fluid= lower pressure
Renin-angiotensin-aldosterone system
Reabsorbs sodium and water
Vasoconstrictor
Renin
From kidneys
Acts on angiotensin
Angiotensin I
Converted by a lung enzyme into angiotensin II
Angiotensin to angiotensin I
Liver substrate
Angiotensin II actions
Strong vasoconstrictor and stimulates aldosterone
Aldosterone does this
Reabsorb sodium and water
Increased fluid
Vascular autoregulation
Keeps perfusion of tissues relatively constant
Essential hypertension
Primary
Most common
Hypertension over a period of time causes
MI
CVA
PVD
Kidney failure
Malignant hypertension
Rapid progression 200/150 AM headache Blurred vision Dyspnea Uremia
Ages of malignant hypertension
30s
40s
50s
Unless intervention occurs promptly in malignant hypertension….
Kidney failure
Left ventricular failure
Heart failure
Stroke
Adrenal-mediated hypertension
Excess of aldosterone
Benign adenomas
Hypokalemia
Essential etiology of hypertension
Family history African American Hyperlipidemia Smoking Older than 60 years, post menopause Excessive sodium: caffeine Obesity Sedentary Alcohol Malnutrition Stress
Secondary etiology of hypertension
Kidney disease Primary aldosteronism Pheochromocytoma Cushing a disease Coartation of aorta Brain tumorS Encephalitis Pregnancy
Drugs that can cause secondary hypertension
Estrogen
Glucocorticoids
Mineralcorticoids
Sympathomimics
Pheochromocytomas
Tumors in adrenal medulla
Produce excess of catecholmines
