10 Questions
What is the common name for high blood pressure that exceeds 140 systolic and 90 diastolic?
Hypertension
What is the primary cause of essential hypertension?
Multifactorial: genetic predisposition and environmental factors
What is the main risk factor for developing hypertension?
All of the above
What is the goal of treatment for hypertension?
To prevent and treat target organ damage
What is the recommended course of treatment for hypertension?
Administration of low-dose, long-acting preparations
What is the effect of diuretics on stroke volume?
Decrease blood volume
What is the mechanism of action of arteriolar vasodilators?
They promote the formation of NO, exerting a vasodilating effect
What is the long-term effect of diuretics on stroke volume?
SV recovers, but PR decreases
What is the mechanism of action of thiazide diuretics?
They inhibit the reabsorption of Na and Cl in the front section of the distal tubulus
What is a common side effect of thiazide diuretics?
Hypokalemia
Study Notes
Blood Pressure Regulation
- Blood pressure is regulated by the interaction of stroke volume (SV) and peripheral resistance (PR)
- Sympathetic nervous system (SNS) and renin-angiotensin-aldosterone system (RAAS) play a crucial role in blood pressure regulation
Normal Blood Pressure and Hypertension
- Normal blood pressure is 120/80 mmHg
- Hypertension is defined as a systemic arterial pressure exceeding 140/90 mmHg
- General narrowing of arterioles is the direct cause of hypertension
- Main risk factors for hypertension include obesity, excessive salt consumption, stressful conditions, sedentary lifestyle, and age
Primary and Secondary Hypertension
- Primary hypertension (~90% of cases) is multifactorial, with genetic predisposition and environmental factors contributing to its development
- Secondary hypertension (~10% of cases) can be caused by other organ changes, such as kidney disease, hormone overproduction, or atherosclerosis
Consequences of Hypertension
- Organ damage, constriction of heart, retina, and kidney vessels
- Heart attack, heart and kidney failure, and visual disturbances
Treatment of Hypertension
- Treatment of co-morbidities and prevention of target organ damage
- Administration of low-dose, long-acting preparations is recommended
- Combined treatment is most often used, with options including fixed combination pills or individualized therapy
Pharmacological Treatment Options
- Reducing stroke volume:
- Diuretics (reduce circulating blood volume)
- Beta-blocking sympatholytics (reduce heart rate and heart muscle function)
- Expanding the vascular system:
- Sympatholytics (central nervous system effect or alpha-sympatholytics)
- Drugs that inhibit the RAAS system (beta-blockers, direct renin inhibitors, ACE inhibitors, angiotensin II receptor blockers)
- Arteriolar vasodilators:
- Directly acting on vessel walls, promoting NO formation and vasodilation
- Ca-channel inhibitors (blockers):
- Reducing intracellular calcium in smooth muscle cells, reducing contraction
Diuretics
- Reduce extracellular volume, leading to decreased blood volume and preload, and ultimately decreased SV
- After 6-8 weeks, SV recovers, but PR decreases, maintaining the effect
- Types of diuretics:
- Thiazides (e.g., hydrochlorothiazide, indapamide)
- Loop diuretics (e.g., furosemide)
- Potassium-sparing diuretics (e.g., eplerenone, aldosterone antagonists)
This quiz covers the regulation of blood pressure, including factors that affect it, normal and hypertensive blood pressure ranges, and the primary and secondary causes of hypertension.
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