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MPharm 2 - PH2113 COPY > Unit 6 - Cardiovascular system 3 > Flashcards

Unit 6 - Cardiovascular system 3 Flashcards

1
Q

What is MAP?

A

Mean arterial pressure

- time weighted average of blood pressure

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2
Q

How is mean arterial pressure calculated?

A

1/3 (Psystolic - Pdiastolic) + Pdiastolic

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3
Q

What is pulse pressure?

A

The difference between systolic and diastolic blood pressure

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4
Q

What does blood pressure provide?

A

The driving force to perfuse organs with blood

- determines perfusion pressure

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5
Q

Why isn’t blood pressure uniform throughout the body?

A

Effects of gravity
- measure at the level of the heart
Cardiac cycle is cyclical

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6
Q

What factors regulate blood pressure?

A

Short term - autonomic nervous system

Long term - Renin-angiotensin-aldosterone system

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7
Q

What is cardiac output?

A

Heart rate x stroke volume

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8
Q

How is MAP calculated?

A

MAP = CO x TPR (total peripheral resistance)

CO = HR x SV

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9
Q

How does the autonomic nervous system regulate blood pressure?

A

Smooth muscle tone changes total peripheral resistance

Vasoconstriction = increased resistance = increased blood pressure

Arterioles provide greatest contribution to changes in total peripheral resistance

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10
Q

How can the resistance to flow be calculated?

A 
R = 8nL/pi r^4
R= resistance
n = viscosity in blood
l = vessel length
r = vessel radius
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11
Q

How does the renin-angiotensin-aldosterone system control blood pressure?

A

Angiotensin II causes arteriolar vasoconstriction, increasing the blood pressure

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12
Q

What factors affect blood pressure?

A

Age
Sex
Population differences

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13
Q

What is the role of the pharmacist in diagnosing and treating hypertension?

A
  • screening those at risk
  • increasing public awareness of risk factors
  • promoting appropriate lifestyle changes to limit risk
  • no immediate perceivable gain
  • regular monitoring and refining of medication
  • ensuring compliance
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14
Q

What does hypertension increase the risk of?

A

Stroke

Coronary heart disease

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15
Q

How can the risk of CV be minimised?

A

Blood pressure < 120/80 mmHg

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16
Q

What is stage 1 hypertension?

A 
Clinic blood pressure is 140/90 mmHg or higher
Subsequent ABPM (ambulatory blood pressure monitoring) or HBPM (home blood pressure monitoring) average blood pressure 135/85 mmHg
17
Q

What is stage 2 hypertension?

A

Clinic blood pressure is 160/100 mmHg or higher

ABPM or HBPM average blood pressure is 150/95 mmHg or higher

18
Q

What is severe hypertension?

A

Clinic systolic blood pressure is 180 mmHg or higher or

Clinic diastolic blood pressure is 120 mmHg or higher

19
Q

How is hypertension diagnosed?

A

Measure blood pressure in both arms whilst patient is sitting, relaxed and arm is supported
- repeat if > 15 mmHg difference and use arm with higher reading
Diagnosis of stage 1 or 2 hypertension should follow elevated BP measurements made over several visits and/or addition or ABPM or HBPM (if ABPM not tolerated)

20
Q

What should be initiated if severe hypertension is observed?

A

Urgent or emergency treatment

21
Q

What should be assessed whilst waiting for hypertension confirmation?

A

Cardiovascular risk
- Qrisk
End organ damage

22
Q

What is the primary aim of treating hypertension?

A

Achieving target BP

Reducing risk of CVD

23
Q

What is primary hypertension?

A

Essential or idiopathic

  • unknown origin
  • lifestyle
  • genetic factors

Accounts for 95% of cases

24
Q

What is secondary hypertension?

A

Elevated blood pressure due to underlying, identifiable cause

Accounts for 5% to 10 % of hypertension in adults.

25
Q

What is pre-hypertension?

A

130 - 139 / 80 - 90 mmHg

26
Q

What is isolated systolic/diastolic hypertension?

A

> 140/90 and <140/>90 respectively

27
Q

What is “white coat” hypertension?

A

Elevated readings in a clinical setting

28
Q

What is masked hypertension?

A

Normal readings in a clinical setting

Elevated readings outside the clinic

29
Q

What is accelerated / malignant hypertension?

A

Sudden onset
Severe hypertension > 180/120 mmHg
Retinal haemorrhage/papilloedema

30
Q

How is pre-hypertension treated?

A

Lifestyle changes
Promotion of regular exercise
Modified healthy/balanced diet (DASH diet)
- reduction in dietary sodium
- discourage excessive caffeine consumption
Reduction in stress and increased relaxation
Reduced alcohol intake
Smoking cessation
Blood pressure monitoring every 5 years
- or annually

MPharm 2 - PH2113 COPY (39 decks)

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