hypertension

Question 1

what is hypertension

Answer 1

persistently elevated arterial blood pressure

Question 2

how does BP link to circadium rhythm

Answer 2

rises at the start of the day and is the lowest in the evening

Question 3

what is primary hypertension

Answer 3

chronically elevated blood pressure with no identifiable cause

Question 4

what is secondary hypertension

Answer 4

has an identifiable cause either disease or drugs

Question 5

what is pseudohypertension

Answer 5

• falsely elevated BP measurement
• vessels are stiff and thick because of calcification and resist compression from BP cuff

Question 6

what is white coat hypertension

Answer 6

clinical BP > home bp

Question 7

what is masked hypertension

Answer 7

home bp > clinical bp

Question 8

what is hypertensive emergencies

Answer 8

hypertension with acute end organ damage

Question 9

what is hypertensive urgencies

Answer 9

hypertension without acute end organ damage

Question 10

what causes hypertension during pregancy

Answer 10

• preeclampsia-eclampsia
• chronic hypertension
  superimposed preeclampsia
• gestational hypertension

Question 11

what are risk factors of hyperenstion

Answer 11

• age
• smoking
• DM
• dyslipidaemia
• obesity
• physical inactivity

Question 12

what is stage 1 BP

Answer 12

140/90 - 159/99

Question 13

what is stage 2 bp

Answer 13

160/100- 179/199

Question 14

what is stage 3 bp

Answer 14

> 180/120

Question 14

what is arterial blood pressure

Answer 14

the pressure in the arterial wall between blood flow and the resistance of blood flow

Question 14

what is arterial BP calculation

Answer 14

ABP = CO x PVR

Question 15

what falls under peripheral resistance

Answer 15

arterial tone

Question 15

what falls under cardiac output

Answer 15

• heart rate
• contractility
• filling pressure
• blood volume
• venous tone

Question 16

what does abnormal neuronal mechanism affect in BP

Answer 16

• overactive sympathetic nervous system
• resetting of baroreceptor reflex systems

Question 17

what abnormalities lead to hypertension development

Answer 17

• abnormal neuronal mechanism
• malfunctions in humoral mechanisms
• defects in peripheral autoregulation
• altered vascular endothelial mechanisms

Question 17

what is the affects of humoral mechanisms malfunctions

Answer 17

• overactive RAAS
• insulin resistance and hyperinsulinemia

Question 18

what is the SNS heart regulation of BP

Answer 18

• increase heart rate
• increase force of contraction
• increase CO
• adrenaline and noradrenaline bind to B1

Question 19

what is the SNS blood vessel regulation of BP

Answer 19

• alpha 1 vasoconstrict increase PVR
• beta 2 vasodilate decrease PVR

Question 19

what is the SNS kidney regulation of BP

Answer 19

• increase renin secretion
• increase ang II
• increase BP

Question 20

how does altered vascular endothelial mechanism affect BP

Answer 20

- endothelial cells has vasodilating substances and vasoconstricting substances - deficiencies can cause excess vasoconstriction

Question 20

how does insulin resistance and hyperinsulinemia affect BP

Answer 20

- increased insulin increases Na, increasing SNS - can induce hypertrophy of vascular smooth muscle - increase intracellular Ca, increase vascular resistance

Question 20

how does the kidney regulate BP

Answer 20

BP drop kidney increases Na and water retention to increase BP

Question 21

what do defects in peripheral autoregulation affect BP

Answer 21

increased Na retention means more water retention so increased BP

Question 22

what are the stages of baroreceptor reflex with increasing BP

Answer 22

1. BP above normal range 2. baroreceptors in carotid sinuses and aortic arch are stimulated 3. increase impulses inhibit cardio stimulatory and vasomotor centre 4. decrease sympathetic impulse, decrease HP and CO 5. decrease vasomotor to vasodilate 6. decrease CO and PVR

Question 23

what are the stages of baroreceptor reflex with decreasing BP

Answer 23

1. decreased BP above normal range 2. baroreceptors inhibited 3. decreased baroreceptors activates cardio stimulatory and vasomotor centre 4. increase sympathetic impulses to heart increase HR and CO 5. vasomotor impulses vasoconstrict 6. increase CO and PVR

Question 23

what increases renin release

Answer 23

- decreased renal perfusion - sympathetic neural activity catecholamines - low Na - hyperkalaemia

Question 23

what does the RAAD system do

Answer 23

regulates sodium, potassium and blood volume

Question 23

where is renin secreted from

Answer 23

juxtaglomerular cells in the kidney

Question 23

how does RAAS affect the adrenal gland

Answer 23

- cortex stimulate aldosterone secretion increase Na reabsorption - medulla stimulate release of catecholamines

Question 23

how does the RAAS system affect the heart

Answer 23

- inotropic and chronotropic effects - cardiac hypertrophy - increases stiffness

Question 23

how does RAAS affect blood vessels

Answer 23

- ang II is a vasoconstrictor - acts directly on vascular smooth muscle - facilitates sympathetic transmission through presynaptic angiotensin

Question 24

how does RAAS affect the CNS

Answer 24

- stimulation of central sympathetic tone - release of ADH inhibits diuresis - stimulation of drinking

Question 25

what are the stages of the RAAS system

Answer 25

1. angiotensinogen binds with renin from the kidneys 2. makes angiotensin I 3. ang I is altered by ACE 4. makes angiotensin II 5. creates AT1 which vasoconstricts and AT2 which vasodilates 6. AT1 triggers aldosterone release 7. increase Na and water retention and K excretion