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M6 13-005
Exam 4: Cardiovascular System- Hypertension
| Term | Definition |
|---|---|
| Normal Systolic Blood Pressure | <120 mm Hg |
| Normal Diastolic Blood Pressure | <80 mm Hg |
| Prehypertension | 120-139/80-89 |
| High Blood Pressure Systolic | arterial blood pressure 140 mmHg or higher |
| High Blood Pressure Diastolic | arterial blood pressure 90 mmHg or greater |
| Dx of HTN | 2 or more separate readings on 2 or more separate occasions |
| Systolic BP | Greatest force caused by CONTRACTION of the LEFT VENTRICLE |
| Diastolic Blood Pressure | Occurs during the RELAXATION phase between hearbeats |
| Arterial Blood Pressure | Pressure exerted by blood on the vessel walls |
| Vasoconstriciton & Vasodialtion | Controlled by sympathetic nervous system & Renin-angiotensin System |
| 3 Different Types of HTN | Primary (Essential), Secondary, Malignant |
| Primary (Essential) HTN | Cause Unknown, Constitutes 90% to 95% of all cases of HTN |
| Non-Modifiable Risk Factors (Essential) | Age, Race, Gender Family Hx |
| Modifiable Risk Factors (Essential) | Smoking, Obesity, High Na+ Diet, Elevated Serum Cholesterol, Oral Contraceptive /Estrogen Therapy, Alcohol, Emotional Stress, Sedentary Lifestyle |
| Untreated Primary HTN | Fibrous Tissue develop in the arterioles, Decreased Tissue perfusion |
| Play an important role in regulating BP | Blood Flow & Peripheral Vascular Resistance |
| Renin is released from the | Kidneys |
| Angiotensin-Converting Enzyme is released from | Lungs |
| Secondary HTN | Identifiable Medical Dx. |
| Conditions associated with Secondary HTN | Renal Vascular Disease, Adrenal Cortex Disease, Coarctation of the Aorta, Head Trauma, Cranial Tumor, Poregnancy-induced HTN |
| Adrenal Cortex Disease | Primary Aldosteronism, Cushing's Syndrome, Pheochromocytoma |
| Malignant HTN | Severe Rapid progressive elevation in BP. Diastolic >120 mmHg |
| Malignant HTN Causes | Damage in the small arterioles in major organs, heart, kidneys, brain eyes. |
| Renin-Angiotensin System | Hormone system that regulates blood pressure and water (fluid) balance. |
| Most distinguishable feature of Malignant HTN | Inflammation to arterioles of eyes (arteriolitis) |
| Malignant HTN most common in | Black males under 40 years old |
| Most common causes of death w/ Malignant HTN | MI, Heart failure, stroke, renal failure |
| Manifestation of HTN | Asymptomatic until VASCULAR CHANGES occur. |
| S/S Advanced HTN | Awaken w/ Headache, blurred vision, Spontaneous Epistaxis |
| Persistent untreated HTN May result in | Target organ (Heart, Kidney, Brain) damage. |
| Assessment of HTN | BP in both arms in SUPINE and SITTING positions. |
| HTN Dx Tests (What do they do) | Evaluate baseline of brain, heart & kidneys |
| HTN Lab Tests | CBC, Electolytes (Sodium, Potassium, Calcium), Lipid Profile, Fasting Blood Glucose, Creatinine, BUN and Urinalysis |
| HTN Dx Tests | Chest Radiograph, ECG and Possible Echo, Intravenous Pyelograph (IVP) |
| Why does HTN often go untreated? | Asymptomatic until target organ damage begins |
| Goal of HTN Management | Keep BP below 140/90 (older adults), 131/85 (younger adults w/ mild HTN) |
| Rx to decrease BP | Anti-hypertensives |
| RX to treat uncomplicated HTN | Diuretics, Beat Blockers, Abgiotensin-Converting Enzyme (ACE) Inhibitors, Angiotensin II Receptor Blockers, Calcium Channel Blockers, Alpha-Agonists |
| Special Rx Considerations for Diabetes Mellitus | ACE inhibitor helps protect the renal function |
| Special Rx Considerations for Heart Failure | ACE Inhibitors, diruetics |
| Special Rx Considerations for MI | Beta Blockers, ACE inhibitors |
| Special Rx Considerations for African-Americans | Calcium Channel Blockers, Diuretics |
| Non-Pharmacological Management | Weight Loss, Reduce Saturated Fats, Limit Alcohol Intake, Exercise, Reduce Sodium Intake, Exercise, Smoking Cessation, Relaxation Techniques |
| Anti-hypertensive Agents Use | Tx of HTN |
| Anti-hypertensive Agent Actions | Lower BP to a normal level (<90 mmHg Diastolic) or lowest level tolerated |
| Anti-hypertensive Therapeutic Goal | Prevention of end-organ damage |
| Anti-hypertensive Side Effects | CNS: Headache -- CV: hypotension, bradycardia, tachycardia -- GI: Nausea, Vomiting |
| Adrenergic Action | Potent vasodilator, improves myocardial contraction, reduces pulmonary congestion, works on the nervous system |
| ACE Inhibitor Action | Blocks the conversion of Angiotension 1 to Angiotension 2 (Prils) |
| Angiotensin II Recetptor Antagonist Action | Block the Angiotension II receptors (Sartans) |
| Beat Blockers Actions | Lols |
| Calcium Channel Blocker Actions | Inhibits the transport of calcium resulting in relaxation of the smooth muscle |
| Common side Effects | Hypotension, Bradycardia, Tachycardia, headache, nausea, vomiting, cough or SOB, Angioedema, ED |
Created by:
jtzuetrong
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