Term
| what is the cut off BP for hypertension |
|
Definition
|
|
Term
| what is the diagnostic criteria for hypertension |
|
Definition
BP of 139/89 +
taken twice and averaged
done at two office visits |
|
|
Term
| what are the 4 ranges of blood pressure |
|
Definition
< 120/80 normal
120/80 - 139/89 pre-hypertension
140/90 - 159/99 stage 1 hypertension
160/100+ stage 2 hypertension |
|
|
Term
| why does BP have to be in a certian range, general statement of what happens if low or high |
|
Definition
low: poor perfusion
high: vessel and organ damage |
|
|
Term
| what are the two causes of hypertension |
|
Definition
systemic vascular resistance (tone) of vessels
increased CO (HR and SV) |
|
|
Term
| what are the three things CO (HR and SV) are dependant on |
|
Definition
|
|
Term
| where is the most impact of vascular tone occuring at |
|
Definition
|
|
Term
| what causes changes in arteriole tone (3) |
|
Definition
neural and hormonal regulation
local factors
a adrenergic constriction receptors
B adrenergic dilation receptors |
|
|
Term
| what stimulates a adrenergic receptors on arterioles |
|
Definition
angiotensin II
catecholamines
thromboxane
leukotrienes
endothelien |
|
|
Term
| what stimulates B adrenergic receptors on arterioles |
|
Definition
|
|
Term
| what are the factors that affect local arteriole regulation |
|
Definition
|
|
Term
| what are the two general steps in the course of hypertension |
|
Definition
asymptomatic (until too late)
symptomatic |
|
|
Term
| what are the complications of hypertension (15) |
|
Definition
retinopathy
sleep apnea
kidney failure
stroke
CAD
PAD
coronary revascularization
cardiac hypertrophy (LV)
hypertensive disease (heart failure)
aortic dissection potentiation
renal failure
MI
athlerosclerosis acceleration
hayline arterolosclerosis
hyperplastic arterolosclerosis |
|
|
Term
| how much of the population has hypertension |
|
Definition
|
|
Term
| what can increase complications of hypertension |
|
Definition
age
african american genetics |
|
|
Term
| what is the prognosis of hypertension |
|
Definition
| with a decrease in BP most complications (IHD, CHF, stroke) are avoided |
|
|
Term
| what are the two types of presentation of hypertension, what is the percent of incidence of each |
|
Definition
benign/idiopathic/essential (asymptomatic) 95%
accelerated/malignant (symptomatic) 5% |
|
|
Term
| what are some conditions that cause hypervolemia and increase CO leading to HTN (6) |
|
Definition
renal artery stenosis
renal disease
hyperaldosteronism
hyperADH
coarctation of the aorta
pregnancy |
|
|
Term
| what are 3 types of conditions that cause increased CO leading to HTN |
|
Definition
hypervolemia
stress
pheochromocytoma |
|
|
Term
| what occurs in pheochromocytoma |
|
Definition
|
|
Term
| what are 9 conditions causing increased vascular resistance |
|
Definition
idiopathic/primary/essential HTN
stress
athlerosclerosis
renal artery disease
pheochromocytoma
thyroid dysfunction
diabetes
cerebral ischemia
cushings |
|
|
Term
| how does renal artery stenosis cause HTN |
|
Definition
narrowing decreases blood to the kidney which causes release of renin and increase in angII
angII causes vasoconstriction increasing BP
angII activates adrenal cortex which releases ALD and increase BP
increase in BP causes HTN |
|
|
Term
| how does stress cause HTN |
|
Definition
SNS activation activates adrenal medulla which releases catecholamines (E+NE)
NE increases CO and vascular resistance
both activate ang II which increases ALD (vasopressin) which increases BP |
|
|
Term
| how does hypertension cause sleep apnea, what are the complications |
|
Definition
not sure
SNS acivation and stress of sleep loss lead to apenia induced hypoxia and hypercapnea |
|
|
Term
| how does HTN cause kidney damage |
|
Definition
| causes glomerular sclerosis which causes decreased function and evuntally disease (which causes more HTN) |
|
|
Term
| what is the criteria for accelerated/malignant htn |
|
Definition
diastole >120
renal failure
retinal hemorrhage and exudates |
|
|
Term
| what is usually the cause of accelerated htn |
|
Definition
|
|
Term
| what are the criteria for benign htn |
|
Definition
increased BV: decreased Na excretion, Na level alterations
increased resistance: vasoconstriction, structural defects |
|
|
Term
| what happens when there is increased vasoconstriction for a long time |
|
Definition
| permanent thickening of the vessel |
|
|
Term
| what two factors must someone have to develop htn |
|
Definition
genetic predisposition
enivornmental factor that modifies genes |
|
|
Term
| hat are 5 enivornmental factors that can start htn |
|
Definition
stress
smoking
obesity
inactivity
increased Na diet |
|
|
Term
| what is the tx for htn (5) |
|
Definition
weight loss
decreased saturated and total fat
decreased Na intake
exercise
limit alcohol |
|
|
Term
| what are two complications htn can cause specificially in small vesses |
|
Definition
hayline arterilisclerosis
hyperplastic arterolosclerosis |
|
|
Term
| define hayline arterolosclerosis |
|
Definition
| hayline wall thickening in arteriole |
|
|
Term
| what occurs in hyperplastic arterolosclerosis, where is the most common location |
|
Definition
onion skining: narrowing of arterioles in concentric rings
kidney |
|
|
Term
| what are three causes of hyperplastic arterolosclerosis initiation |
|
Definition
usually in malignant HTN
acute BP elevation
renal or cerebral A injury |
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