Hypertension Flashcards
(36 cards)
What two factors affect blood pressure?
Volume of blood (cardiac output), and compliance of arteries (systemic vascular resistance)
What are some neural cardiovascular reflexes that help with RAPID compensation of blood pressure?
Baroreceptor reflexes, chemoreceptor reflexes and brain (CNS) ischemic response (like in increased ICP, etc)
What are some hormonal responses to blood pressure changes that take effect for intermediate/short term responses?
Catecholamines, RAAS, vasopressin
What blood pressure regulating system is responsible for long term BP management?
Renal body fluid control system
What is natriuresis?
Getting rid of sodium
How do the kidneys control high blood pressure/extra cellular fluid volume (ECFV)?
They excrete excess fluid and sodium in the urine. Diuresis and natriuresis.
How do the kidneys compensate for low blood pressure/low ECFV?
The kidneys excrete less fluid and sodium than ingested.
What happens to BP with age?
Systolic and diastolic bp increase with age due to blood vessel stiffening and narrowing. Systolic more so than diastolic.
What happens to BP when someone is male and aging?
BP’s tend to have higher BP with increased age.
When we exercise, how does this affect BP?
BP increases transiently with physical or psychological stress
Does gravity have an effect on BP?
Yes, BP can vary in relation to vertical distance from heart.
Does the time of day have an effect on BP?
Yes - the circadian variations account for your lowest BP happening at night between 2-5 am. The highest is shortly after waking.
What’s a goal BP for someone with diabetes?
Less than 130/80
What’s a goal BP for someone that has kidney disease?
<140/90
What’s a goal BP for someone that’s over 80 years old?
<150/90
What is primary or “essential” hypertension?
No clear identifiable cause. Happens in one’s 50’s or 60’s and is the most common cause of htn (90-95% of people have it). Risk factors are: kidney function changes, RAAS activity, SNS hyperactivity, and intracellular sodium and calcium levels.
What can increase the arterial by?
Shifting the renal output curve toward a higher pressure or increasing the intake of salt and water.
What are some non-modifiable risk factors for htn?
Family hx, advanced age (>45 in men, >55 in women), men more often than women, and race (south asian and african american)
What are some modifiable risk factors for htn?
High salt diet, abdominal obesity (sns activation by leptin, increased blood vessel length), sedentary lifestyle, poor dietary habits (high fat, low fibre, and potassium intake), impaired glucose intolerance or diabetes, and stress (activation of SNS and ADH and cortisol), cigarette smoking, and ETOH.
What is secondary htn?
It’s htn caused by a known condition that increases BP or other exogenous conditions. Can be corrected or cured through surgery other other med conditions. Ex: hyperaldosteronism or renovascular dx, Acute and chronic kidney disorders, hyperthyroid, cushings, pheochromocytoma.
What is hyperaldosteronism?
A condition that makes too much aldosterone - causing sodium and water retension. Ex: adrenal adenoma, idiopathic adrenal hyperplasia, Acute and chronic kidney disorders, hyperthyroid, cushings, pheochromocytoma.
What’s a symptom of hyperaldosteronism besides low potassium?
Hypokalemia
What is renovascular dx?
Renal artery stenosis due to athersclerosis. Fibromuscular dysplasia (non inflammatory vascular dx). Reduced renal blood flow activates the RAAS which causes angiotensin II to activate aldosterone. Also affects K+ levels.
What might you find on a physical assessment of someone with renovascular disease?
A bruit because of the renal artery obstruction.
