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Flashcards in week 4 - hyper tension Deck (19)
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1

Factors Influencing Blood Pressure

bp= CO x Systemic Vascular
Resistance

2

hypertension

Hypertension is sustained elevation of BP
Systolic blood pressure  140 mm Hg
Diastolic blood pressure  90 mm Hg

***The exception is the diabetic patient! These parameters define hypertension in this population
SBP >130
DBP>80

3

normal bp

120/80

4

prehypertension

120-139/80-89

5

stage 1 hypertension

140-159/90-99

6

stage 2 hypertension

equal or more than 160/100

7

HIGH BP IS DEFINED AS
PERSISTENT BP OVER

140/90

Elevated readings must be present on at least 3 occasions
over several weeks

8

Primary (Essential) Hypertension

- Elevated BP with no known cause
- 85-90% of all cases

9

Secondary Hypertension

Elevated BP with a specific cause
- Approximately 10% of adults

10

Primary HTN: Risk Factors

**Family Hx of HTN
 Sodium intake
Excessive alcohol intake
Physical inactivity
Excess calorie intake
Low potassium intake
**age > 60
Hyperlipidemia
**Ethnicity
Obesity
Smoking
Stress
intake K+, Ca+, Mg+

11

Secondary Hypertension: Risk Factors

• Coarctation of aorta
• Renal disease
• Endocrine disorders
• Neurological disorders

12

HypertensionClinical Manifestations

MAY experience :Dizziness or fainting (syncope)
Headache
Facial flushing
*****Usually asymptomatic until it becomes severe and target organ disease has occurred

13

HypertensionComplications

The common complications are
target organ diseases occurring in the:

Heart
Brain
Kidney
Eyes

14

Hypertensive Heart Disease

Coronary artery disease (CAD)
Left ventricular hypertrophy (LVH)
Heart failure (HF)
Cerebrovascular Disease
-Stroke
Peripheral Vascular Disease
Nephrosclerosis
Retinal Damage

15

- Use arm with higher reading for subsequent measurements

- BP highest in early morning, lowest at night
Describe patient teaching for self-monitoring

16

HypertensionDiagnostic Studies

Routine urinalysis
Serum electrolytes
BUN and serum creatinine
Serum lipid profile
ECG
**these will identify secondary HTN causes or complications of HTN

17

• “White coat” phenomenon AND
Masked HTN

high bp in clincal settings and high bp in home settings

18

DASH Diet (Dietary Approaches to Stop Hypertension)

2-3 servings of low fat milk, yogurt, cheese for calcium
8-10 helpings of fruit and vegetables (bananas, OJ and spinach for potassium)
2400 mg of sodium or less than 6 mg of table salt a day
diet low in saturated fats and rich in fruits/vegetables and low fat dairy foods
limit alcohol
avoid fast food
weight loss

19

Drug Therapy

ACE (angiotensin converting enzyme) inhibitors
ARBs (angiotensin receptor blockers)
Calcium channel blockers (CCBs)
Beta Blockers
Diuretics