Lecture One : Hypertension

Question 1

what is the arterial pressure of systemic circulation called

Answer 1

blood pressure

Question 2

pressure gradient generates what?

Answer 2

blood flow

Question 3

which vital organs does bp maintain a constant blood flow to

Answer 3

heart, brain, and kidneys

Question 4

what components make up arterial pressure

Answer 4

cardiac output x peripheral resistance

Question 5

what components make up cardiac output

Answer 5

stroke volume x heart rate

Question 6

what components make up stroke volume

Answer 6

myocardial contractility and size of the vascular compartments

Question 7

what components make up peripheral resistance

Answer 7

vascular structure and vascular function

Question 8

what are some intrinsic factors of blood pressure

Answer 8

HR, SV, and peripheral resistance

Question 9

What are the components involved with peripheral resistance

Answer 9

vessel diameter, vessel length, vessel integrity, and blood viscosity

Question 10

what are some extrinsic factors of blood pressure

Answer 10

diet, exercise, emotional state, disease, sleep, drugs, alcohol, stress, and obesity

Question 11

what is the desired systolic bp

Answer 11

90-119

Question 12

what is the desired diastolic bp

Answer 12

60-79

Question 13

Chronic elevated blood pressure

Answer 13

hypertension

Question 14

hypertension readings are usually

Answer 14

140/90 or greater

Question 15

what affects the risk of developing HTN

Answer 15

age, race, and sex

Question 16

T/F; CVD risk doubles for every 20/10 increase above 115/75

Answer 16

True

Question 17

This type of HTN is 95% of cases; no underlying disease

Answer 17

Essential Primary HTN

Question 18

Essential Primary HTN Etiologic Factors

Answer 18

Age, sex, low birth weight, race/ethnicity, family Hx, smoking, obesity, diabetes, sedentary lifestyle, suboptimal diet, etc

Question 19

What are the etiologies of Essential Primary HTN

Answer 19

autonomic system ( homeostatic recalibration ), renin-angiotensin - aldosterone system ( association with obesity ), Reactive oxygen species ( elevated vascular tone) , genetic predisposition ( multifactorial: renal salt handling )

Question 20

This is a type of HTN where the etiology can be identified ; 5-10 % of cases; assoc with Pheochromocytoma ( adrenal tumor that secretes vasoconstrictive hormones )

Answer 20

secondary HTN

Question 21

what causes HTN in 5 % of users of high dose HC

Answer 21

hormonal contraceptives and HTN

Question 22

risk factors for HTN in women

Answer 22

overweight, history of HTN in pregnancy, predisposing condition, family Hx, cigarettes

Question 23

in what trimester can HTN develop

Answer 23

third trimester

Question 24

what is white coat HTN

Answer 24

increase up to 20/10 above pts normal BP ( may not be benign )

Question 25

What is the goal BP for HTN Tx pts

Answer 25

140/90 or less

Question 26

what are some tx meds for HTN

Answer 26

thiazide diuretics, B-blocker, Ca antagonist, ACE inhibitor, Angiotensin II blocker, and Adrenergic inhibitors

Question 27

What is a hypertensive urgency

Answer 27

BP of >180/110 , no end organ damage; symptoms would be severe HA, shortness of breath, nosebleeds, severe anxiety

Question 28

What is a hypertensive emergency

Answer 28

BP > 180/110, end organ damage ; chest pain, shortness of breath, back pain, numbness/.weakness/ changes in vision, trouble speaking ; immediate hospitalization ; potential complications are stroke and pulmonary edema

Question 29

what is a target organ for HTN that's important

Answer 29

retina

Question 30

what is the most common ocular manifestation of HTN

Answer 30

Hypertensive retinopathy; 50-80% chance of developing it

Question 31

% increase risk of stroke with mild HTN ret

Answer 31

35%

Question 32

% increase risk of stroke with moderate/ severe HTN ret.

Answer 32

137%

Question 33

symptoms of hypertensive retinopathy

Answer 33

usually asymptomatic and may have decreased vision

Question 34

This is a gradual reduction of blood flow to the retina

Answer 34

hypertensive retinopathy

Question 35

this is a term that rep. swollen axons with intracytoplasmic bodies and rep. hypertensive retinopathy

Answer 35

cotton wool spots

Question 36

changes such as A/V crossing changes, cotton wool spots, and hemorrhages comes with what type of retinopathy

Answer 36

chronic hypertensive retinopathy

Question 37

these changes such as retina edema, cotton wool spots, and macular star are what type of retinopathy

Answer 37

acute ( malignant) hypertensive retinopathy