Cardiovascular Diseases & Hypertension

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Questions and Answers

In a patient exhibiting signs of hypertensive emergency with concomitant end-organ damage, which of the following blood pressure thresholds would necessitate immediate and aggressive intervention to mitigate further harm?

  • Systolic BP > 190 mmHg with Diastolic BP > 125 mmHg
  • Systolic BP > 180 mmHg and/or Diastolic BP > 120 mmHg (correct)
  • Systolic BP > 170 mmHg with Diastolic BP > 115 mmHg
  • Systolic BP > 160 mmHg with Diastolic BP > 110 mmHg

A researcher is investigating the effects of various antihypertensive medications on vascular remodeling. Which of the following mechanisms of action would be LEAST likely to influence the structural integrity and long-term adaptation of arterial walls in response to chronic hypertension?

  • Blockade of angiotensin II type 1 (AT1) receptors
  • Direct arterial vasodilation via nitric oxide (NO) potentiation
  • Inhibition of angiotensin-converting enzyme (ACE)
  • Selective antagonism of alpha-1 adrenergic receptors (correct)

In a complex physiological scenario involving a previously healthy individual undergoing intense endurance exercise in extreme environmental conditions, which of the following hormonal responses would be MOST likely to counteract the exercise-induced hypotension upon cessation of activity, potentially leading to a transient hypertensive state?

  • Increased secretion of atrial natriuretic peptide (ANP) to promote vasodilation.
  • Enhanced release of endogenous nitric oxide (NO) from endothelial cells.
  • Activation of the renin-angiotensin-aldosterone system (RAAS) due to renal hypoperfusion. (correct)
  • Suppression of antidiuretic hormone (ADH) release to reduce fluid retention.

A patient with a history of poorly controlled hypertension presents with acute pulmonary edema and severe respiratory distress. Which of the following interventions would be the MOST appropriate INITIAL step in managing this patient's condition?

<p>Rapid intravenous bolus of a loop diuretic (e.g., furosemide) along with supplemental oxygen (B)</p> Signup and view all the answers

Which statement accurately describes the interaction between cardiac output (CO) and total peripheral resistance (TPR) in determining blood pressure (BP)?

<p>BP is the product of CO and TPR, reflecting the volume of blood pumped per minute and the resistance the heart must overcome to circulate blood. (D)</p> Signup and view all the answers

Which statement accurately describes the role of natriuretic hormones in blood pressure regulation?

<p>Promote vasodilation and sodium excretion, leading to decreased blood volume and blood pressure. (C)</p> Signup and view all the answers

In the context of hypertension-induced vascular remodeling, which of the following cellular processes is MOST directly implicated in the long-term structural changes observed in arterial walls?

<p>Increased expression and activity of matrix metalloproteinases (MMPs). (D)</p> Signup and view all the answers

Which of the following statements BEST describes the rationale for prioritizing lifestyle modifications as a primary intervention strategy in the management of Stage 1 hypertension, particularly in individuals with low overall cardiovascular risk?

<p>Lifestyle modifications address multiple modifiable risk factors simultaneously, potentially preventing or delaying the progression of hypertension and reducing overall cardiovascular risk. (A)</p> Signup and view all the answers

A researcher is designing a study to investigate the impact of a novel therapeutic intervention on nocturnal blood pressure dipping in elderly patients with resistant hypertension. Which of the following methodological considerations would be MOST critical to ensure accurate and reliable assessment of nocturnal blood pressure patterns?

<p>Implementing continuous ambulatory blood pressure monitoring (ABPM) with validated devices and standardized protocols. (C)</p> Signup and view all the answers

Which of the following statements accurately describes the current understanding of the role of genetics in the pathogenesis of essential hypertension?

<p>Essential hypertension is a complex polygenic disorder involving multiple genes and environmental factors, with each gene contributing a small effect. (C)</p> Signup and view all the answers

In evaluating a patient for secondary hypertension, which of the following clinical scenarios would warrant the STRONGEST suspicion for primary aldosteronism as the underlying cause?

<p>A middle-aged patient with unexplained hypokalemia, resistant hypertension, and an adrenal incidentaloma. (B)</p> Signup and view all the answers

Which of the following statements accurately portrays the influence of dietary sodium intake on blood pressure regulation, particularly in salt-sensitive individuals?

<p>Salt-sensitive individuals experience exaggerated increases in blood pressure in response to increased dietary sodium intake, often due to impaired renal sodium excretion and increased sympathetic nervous system activity. (A)</p> Signup and view all the answers

A researcher is investigating the potential interactions between the renin-angiotensin-aldosterone system (RAAS) and the sympathetic nervous system (SNS) in the context of hypertension. Which of the following accurately describes a well-established synergistic mechanism between these two systems that contributes to elevated blood pressure?

<p>Angiotensin II enhances norepinephrine release and potentiates its vasoconstrictive effects, while SNS activation stimulates renin release from the kidneys. (A)</p> Signup and view all the answers

A patient with long-standing, poorly controlled hypertension develops new-onset atrial fibrillation. Which of the following echocardiographic findings would provide the STRONGEST evidence that the hypertension has directly contributed to the development of atrial fibrillation in this patient?

<p>Left ventricular hypertrophy (LVH) with diastolic dysfunction and left atrial enlargement. (C)</p> Signup and view all the answers

A 35-year-old female patient with no prior medical history presents with a sudden onset of markedly elevated blood pressure (210/130 mmHg) and signs of end-organ damage. Further investigation reveals elevated levels of urinary metanephrines and normetanephrines. Which of the following underlying conditions is the MOST likely cause of this patient's hypertensive crisis?

<p>Pheochromocytoma, a catecholamine-secreting tumor of the adrenal medulla. (A)</p> Signup and view all the answers

In a clinical trial evaluating the effects of a novel antihypertensive agent, researchers observe a significant reduction in systolic blood pressure (SBP) but a paradoxical increase in diastolic blood pressure (DBP) in a subset of participants. Which of the following mechanisms could BEST explain this unexpected finding?

<p>Selective blockade of vascular beta-2 adrenergic receptors, leading to unopposed alpha-adrenergic vasoconstriction. (A)</p> Signup and view all the answers

A patient with established hypertension presents with worsening renal function and an increase in serum creatinine following the initiation of an angiotensin-converting enzyme (ACE) inhibitor. Which of the following underlying conditions should be MOST strongly suspected as contributing to this acute decline in renal function?

<p>Atherosclerotic renal artery stenosis. (C)</p> Signup and view all the answers

Compared to arteries, which statement is accurate about the structure and function of veins?

<p>Veins have valves to prevent the backflow of blood due to lower pressure. (C)</p> Signup and view all the answers

Which is a known modifiable risk factor for CVD?

<p>Smoking (A)</p> Signup and view all the answers

How would you describe the influence of genetics, race, age, obesity, diet/sodium intake and alcohol consumption on the development of hypertension?

<p>Potentially influential, with each factor possibly increasing the likelihood of developing hypertension, especially in combination. (A)</p> Signup and view all the answers

Upon reviewing the arterial blood pressure readings for a patient you notice a consistent pattern of elevated systolic blood pressure, but normal diastolic blood pressure. What would you diagnose the patient with?

<p>Isolated systolic hypertension (D)</p> Signup and view all the answers

What causes Primary or Essential HTN?

<p>Unknown cause (C)</p> Signup and view all the answers

Which statement best describes the cascade of the Renin-Angiotensin-Aldosterone System (RAAS)?

<p>Angiotensin II stimulates aldosterone secretion. (C)</p> Signup and view all the answers

How do Beta-1 adrenergic receptors impact blood pressure??

<p>Increases heart rate and contractility (A)</p> Signup and view all the answers

Which of the following statements BEST describes the primary mechanism by which increased dietary potassium intake lowers blood pressure?

<p>Potassium promotes vasodilation and renal sodium excretion, counteracting the effects of sodium retention and reducing blood volume. (A)</p> Signup and view all the answers

Which of the following lipid profile patterns would be considered the MOST atherogenic and predictive of cardiovascular events in patients with hypertension?

<p>Elevated low-density lipoprotein cholesterol (LDL-C), high triglycerides, and low HDL-C (D)</p> Signup and view all the answers

Which of the following best describes the blood pressure classification for Hypertensive Urgency?

<blockquote> <p>180 mmHg for Systolic and &gt; 120 mmHg for Diastolic (B)</p> </blockquote> Signup and view all the answers

What is the MOST accurate method of measuring or evaluating hypertension?

<p>An average of two or more readings at different visits after an initial screening (B)</p> Signup and view all the answers

Which of the following is the most important goal for a patient being diagnosed with hypertension?

<p>To reduce cardiovascular and renal morbidity and mortality (C)</p> Signup and view all the answers

A hypertensive individual's blood pressure consistently measures above 130/80 mmHg. According to the ACC/AHA guidelines, what is the first-line of treatment that should be used for this individual?

<p>Lifestyle Modifications (C)</p> Signup and view all the answers

In the context of managing hypertension, which of the following laboratory tests is MOST useful in evaluating for potential end-organ damage affecting the kidneys?

<p>Urinalysis with microalbuminuria (A)</p> Signup and view all the answers

Which of the following lifestyle modifications would have the greatest impact on SBP if implemented?

<p>Healthy Diet (B)</p> Signup and view all the answers

What is the clinical recommendation for alcohol consumption in a hypertensive patient?

<p>Reduce the consumption to &lt;2 drinks daily for men and ≤1 drink daily for women. (D)</p> Signup and view all the answers

According to the referenced slide content, what does BP equal?

<p>BP=CO × TPR (B)</p> Signup and view all the answers

Which is not a risk factor for cardiovascular disease?

<p>Excessive Excercise (C)</p> Signup and view all the answers

A 60 year old smoker is diagnosed with heart disease, what is the next step?

<p>Immediate smoking cessation (C)</p> Signup and view all the answers

If the body released Anti-Diuretic hormone (ADH), what would happen to the patient's blood pressure?

<p>The patient's blood pressure would increase (D)</p> Signup and view all the answers

In the complex interplay of vascular function, which of the following scenarios would MOST likely precipitate endothelial dysfunction, initiating a cascade of events leading to hypertension?

<p>Chronic exposure to fine particulate matter (PM2.5) air pollution in a genetically predisposed individual with latent insulin resistance (D)</p> Signup and view all the answers

Considering the intricate balance of blood flow dynamics, which of the following conditions would MOST severely impede laminar blood flow, predisposing an individual to vascular injury and hypertension?

<p>Advanced atherosclerosis characterized by significant plaque formation and arterial stenosis. (B)</p> Signup and view all the answers

In a research study evaluating the effects of various antihypertensive agents on arterial remodeling, which of the following cellular mechanisms would offer the MOST compelling therapeutic target for reversing hypertension-induced structural changes in arterial walls?

<p>Attenuation of NADPH oxidase-derived superoxide production in adventitial fibroblasts. (A)</p> Signup and view all the answers

Which of the following humoral mechanisms is MOST critically involved in the long-term potentiation of hypertension, particularly in individuals with a genetic predisposition to salt sensitivity and impaired renal sodium excretion?

<p>Resetting of the pressure-natriuresis relationship due to chronic activation of the sympathetic nervous system. (A)</p> Signup and view all the answers

A 45-year-old African American male with a family history of early-onset cardiovascular disease presents with newly diagnosed Stage 2 hypertension and no other apparent risk factors. Which of the following diagnostic strategies would be MOST appropriate to rule out secondary causes of hypertension and guide further management?

<p>Comprehensive evaluation including renal artery Doppler ultrasound, plasma aldosterone/renin ratio, and 24-hour urinary catecholamines. (A)</p> Signup and view all the answers

In the context of resistant hypertension, which of the following therapeutic strategies would be the MOST effective in mitigating the sustained activation of the sympathetic nervous system and restoring blood pressure control?

<p>Referral for renal denervation as a last-line interventional strategy to disrupt sympathetic nerve activity in the kidneys. (D)</p> Signup and view all the answers

Considering the intricate relationship between dietary factors and blood pressure regulation, which of the following dietary interventions would MOST effectively reduce SBP in a salt-sensitive, obese individual with a sedentary lifestyle and a habitual intake of processed foods?

<p>Implementation of a Mediterranean diet rich in fruits, vegetables, whole grains, legumes, and olive oil, with moderate intake of fish and poultry. (A)</p> Signup and view all the answers

In a complex clinical scenario involving a patient with long-standing, uncontrolled hypertension and advanced chronic kidney disease, which of the following laboratory findings would MOST strongly advocate for cautious titration and close monitoring during the initiation of ACE inhibitor therapy?

<p>Bilateral renal artery stenosis with a significant gradient on Doppler ultrasound. (B)</p> Signup and view all the answers

Which of the following statements MOST accurately describes the rationale behind prioritizing evening dosing of certain antihypertensive medications in individuals exhibiting a non-dipping nocturnal blood pressure pattern?

<p>Evening dosing aligns with the circadian rhythm of blood pressure regulation, optimizing blood pressure control during nighttime hours and reducing cardiovascular event risk. (C)</p> Signup and view all the answers

A researcher is investigating the impact of a novel therapeutic intervention on vascular smooth muscle cell (VSMC) phenotype in hypertensive rats. Which of the following molecular markers would provide the STRONGEST evidence of VSMC phenotypic switching from a contractile to a synthetic state, contributing to vascular remodeling?

<p>Enhanced expression of vimentin and collagen type I. (A)</p> Signup and view all the answers

In a patient presenting with hypertensive urgency, but without acute end-organ damage, which of the following pharmacological approaches represents the MOST appropriate strategy for controlled BP reduction?

<p>Administering a combination of oral short-acting antihypertensive agents, such as captopril and labetalol, with close monitoring over several hours. (A)</p> Signup and view all the answers

A 58-year-old male with a history of poorly controlled hypertension presents with acute-onset severe headache, blurred vision, and altered mental status. Initial blood pressure reading is 220/140 mmHg. Which of the following diagnostic modalities would be MOST crucial in differentiating between hypertensive encephalopathy and acute ischemic stroke as the underlying cause of his symptoms?

<p>Non-contrast computed tomography (CT) scan of the head to rule out intracranial hemorrhage. (C)</p> Signup and view all the answers

Considering the multifaceted etiology of primary (essential) hypertension, which of the following pathophysiological mechanisms is LEAST likely to contribute to the development and progression of elevated blood pressure?

<p>Upregulation the compensatory action of atrial natriuretic peptide (ANP) to counteract increased sodium retention (C)</p> Signup and view all the answers

Which of the following best explains the mechanism for Blood Pressure reduction via the DASH diet?

<p>Lowers BP via a reduction in saturated fats and cholesterol (A)</p> Signup and view all the answers

A patient with a known history of hypertension and peripheral artery disease (PAD) is being evaluated for the initiation of statin therapy. Which of the following lipid profile parameters would be the MOST relevant in guiding the decision to initiate statin therapy and determining the appropriate intensity of treatment?

<p>LDL-cholesterol level but specifically in conjunction with ASCVD risk score, as it is the primary target for statin therapy in patients with established ASCVD. (B)</p> Signup and view all the answers

Flashcards

Cardiovascular Diseases (CVD)

A disease class that involves the heart and blood vessels.

Arterial Blood Pressure

Increased pressure in the arteries, exerting force as blood passes through.

Systolic Blood Pressure (SBP)

The peak pressure in the arteries during heart muscle contraction.

Diastolic Blood Pressure (DBP)

The pressure in the arteries when the heart is relaxed between beats.

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Pulse Pressure

The difference between systolic and diastolic blood pressure.

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Mean Arterial Pressure (MAP)

Average arterial pressure during a single cardiac cycle.

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Hypertension (HTN)

Systemic blood pressure that is consistently elevated.

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Cardiovascular diseases

Diseases, such as HTN, atherosclerosis, CAD and Arrhythmias.

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Cardiovascular diseases

The leading cause of death worldwide.

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Atherosclerosis

This heart disease is often due to plaque buildup in the arteries.

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Coronary Artery Disease (CAD)

Condition where arteries supplying blood/oxygen to heart muscle become hardened/narrowed.

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MI/Angina

Chest pain or discomfort due to reduced blood flow to the heart muscle.

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Arrhythmias

Irregular heartbeats, too fast, too slow, or erratic.

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Heart Failure (HF)

The heart's inability to pump enough blood to meet the body's needs.

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Cerebrovascular Disease (Stroke)

When blood flow to the brain is interrupted, causing damage.

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Peripheral Vascular Disease

Diseases of the blood vessels outside the heart and brain.

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Congenital Heart Disease

Heart defects present at birth.

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Rheumatic Heart Disease

Heart disease caused by rheumatic fever.

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Risk Factors for CVD

Modifiable and non-modifiable factors that increase the risk of Cardiovascular disease.

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Age

The risk of CVD increases with this non-modifiable factor.

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Race

Race is a non-modifiable risk factor, with higher risks for certain groups.

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Gender

Gender is a significant CVD risk factor, differences influenced by hormones and lifestyle.

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Postmenopausal Status

Postmenopausal status is a risk for females due to reduced estrogen.

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Family History

A history that may increase the risk of hypertension.

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Hypertension (HTN)

This condition can increase the risk of CVD.

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Diabetes Mellitus (DM)

A metabolic disorder that can increase the risk of CVD.

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Dyslipidemia

An abnormal amount of lipids in the blood. Increases the Risk of CVD.

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Smoking

A detrimental habit that increases the risk of CVD.

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Obesity

Excess body weight increases the risk of CVD.

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Physical Inactivity

Lack of physical activity increases the risk of CVD.

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Excessive Alcohol

Excessive intake can harm the cardiovascular system.

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Illicit Drug Use

Illegal substance use harms the cardiovascular system.

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Stress

Can trigger or worsen CVD.

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Chronic Inflammation

Persistent inflammation increases the risk of CVD.

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Arterial blood pressure

Refers to the pressure exerted by the blood against the walls of the arteries.

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Systolic Pressure

This is equal to the pressure when the heart contracts.

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Diastolic Pressure

Pressure in the arteries when the heart rests between beats.

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Elevated Systemic Blood Pressure

When elevated, indicates need for lifestyle changes or medication.

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Blood Pressure Reading

A reading above a specified threshold can indicate hypertension.

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White-Coat Hypertension

Where elevated BP is recorded in a clinical enviornment but its normal otherwise.

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Isolated systolic hypertension

Elevated systolic and normal diastolic

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Hypertensive Emergency

Severe elevation with evidence of end-organ damage.

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Hypertensive Urgency

Significantly elevated BP, without end-organ damage.

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Resistant Hypertension

When a person BP is consistently high even when taking medication.

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Hypertension

Affects a large percentage of adults with major health consequences.

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Incidence/Prevalence Increase

The increase with the populations getting older.

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Secondary Hypertension

Can have multiple causes including kidney function.

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Primary HTN Mechanisms

Includes humoral, neural, peripheral, and vascular endothelial factors.

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Humoral Mechanism

Involves hormones like RAAS and natriuretic peptides.

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RAAS

Includes the Renin-Angiotensin-Aldosterone System.

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BP Treatment Goal

The main goal is to reduce cardiovascular and renal morbidity/mortality.

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Goal in Managing HTN

Reduce the cardiovascular and renal health issues related to HBP.

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Strategies to achieve optimal BP

Lifestyle adjustments and medications help in controlling readings.

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Lifestyle Modifications

Emphasizes weight loss, limited alcohol, physical activity, and reduce amounts.

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Lifestyle Modifications

Includes dietary calcium, limits alcohol intake and sodium.

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Study Notes

  • Cardiovascular diseases include hypertension

  • A stroke is the same as apoplegia

  • Isquemia is greater than hemorragic

  • Dra. Jennifer Guzmán-Badillo is a professor at Office 37 at [email protected]

Objectives

  • Discuss the structure of blood vessels and their functions with blood flow principles.
  • Discuss cardiovascular diseases, risk factors, and common conditions associated with vascular disease.
  • Define hypertension, arterial blood pressure, systolic/diastolic blood pressure, pulse pressure, and mean arterial pressure.
  • Explain how cardiac output and peripheral vascular resistance determine systolic and diastolic blood pressure.
  • Describe humoral, neural, peripheral, and vascular mechanisms for blood pressure regulation.
  • Differentiate between primary and secondary hypertension.
  • Describe the influence of genetics, race, age, obesity, diet, sodium intake, and alcohol consumption on hypertension development.
  • Describe behavior modification strategies for hypertension prevention and treatment.
  • Explain how to measure arterial blood pressure.

Blood Vessel Structure and Function

  • Blood vessels are innervated by the CNS
  • They protect the inner structure
  • Elasticity is very important
  • Tunica externa is the outer coat, Tunica media (middle) and Tunica intima (inner).
  • The function of blood vessels is to contract or dilate
  • Collagen provides protection.
  • Elastic fibers provide elasticity.
  • Plaque grows in the connective tissue
  • Ata presion Masera endotelio
  • Endothelial Dysfunction:
    • Blood flow alteration
    • Platelet adhesion
    • Blood clotting
    • Vascular resistance
    • Inflammatory reactions
  • Disfunction = damage
  • Lumen is flow of blood, which is laminar
  • Blood is strong in the middle - suave en endotelio
  • Endotelio protects the vasal system
  • The most important of blood vessel is the tunica intima

Blood Vessel Structure

  • Arteries resist blood flow and pressure changes
  • Veins have capacitance to expand and store blood
  • Arteries have a thicker tunica media with more smooth muscle to resist blood flow and pressure
  • Veins have valves to prevent backflow and return blood to the heart
  • There is an intercambio de gases
  • The capas are middle layer, inner layer, and outer layer

Blood Flow in Cardiovascular System

  • Sangre oxigenada sangre al cerebro
  • Superior = carotid
  • The is a sistema
  • Laminar flow is a system

Cardiovascular Diseases (CVD)

  • Cardiovascular disease is in the heart and vasos sanguineos
  • It is a class of diseases involving the heart and blood vessels.
  • CVD is the leading cause of death worldwide
  • Roughly 20.5 million people (38%) died from CVD which a high number of the people padece de CVD
  • Approximately 127 million people (38%) in the USA are affected.

Cardiovascular Diseases

  • HTN: Hypertension
  • Atherosclerosis is coronary artery disease
  • CAD is ruptureo sangre al corazon
  • MI/Angina is infarto miocardo pain
  • Arrhythmias
  • HF: Heart Failure
  • Músculo se agota and there is liquid in the lungs
  • Cerebrovascular Disease (stroke) apoplegia
  • Peripheral vascular disease can show
  • Congenital heart disease occur at birth
  • Rheumatic heart disease is caused by S- pyogens and damages the valve

Risks Factors for CVD

  • Age is greater with incidence

  • Race :Raza negra

  • Corticosteroia protegen y ya no estin during gender

  • Gender is Male greater than Female until menopause

  • Famale is greater than male ater la manopausia

  • People on Postmenopausal status are at more risk

  • Also, Family History, HTN, DM, Hyperlipidemia

  • Triada =

  • Hyperlipidemia = Hipertensión

  • People with detrimental smoking, activo y pasivo are at greater risk

  • Obesity can increased health risk BMI >30

  • Physical inclativity

  • Alcohol moderado it ok Pen ei uso crónico es malo

  • Excessive Alcohol

  • Illicit drug use cocaina, heroina

  • People with Stress

  • Chronic Inflammation

Cardiovascular Disease: Hypertension

  • Hypertension

Definitions

  • Arterial blood pressure is the pressure in the arterial wall
  • Systolic pressure is the pressure of contraction to take out sangre
  • The diastolic pressure part is relajada y al llenarse ejerce prsion
  • Diastolic also to take out fuerza en el llenado
  • Hypertension is BP over > 130/80mmHg
  • Cardiac output = is cuanta sangre sale por Stroke volumen: cantidad
  • Cardiac output - Cardiac output Total peripheral resisance
  • BP=CO × TPR, Si aumento CO y TPR = aumento BP-
  • Heart rate : CO= sangre
  • MAP= 1/3 SBP + 2/3 DBP - The corazon is in tempo en llenado ~100

Blood Pressure

  • Pre-charge increases with increase TPR needs fuerza Sístole for sacarla

  • For lower heart rate one need periferical and diminue TPR

  • Sístole can be controlled vasodilation and the reverse

  • Pre-charge = return of sangre

  • During the aumeto de TPR, you will need fuerza extra for vencer Diástole

  • You need carga -

  • fuerza de contracción Sístole

  • sangre - aorta

  • Sangre acumulada ejerce fuerza en ventrículo diastole

  • od pressure : fuerza ejercise sobre vasar sangre

Systolic Blood Pressure/ Diastolic Blood Pressure

  • The presión de llenado is poscarga
  • The presión de llenado

Definitions

  • Pulso approx 40
  • Difference between Pulse Pressure is SBP and DBP is efecto neto
  • White-coat hypertension can occur in a clinical setting, normal otherwise
  • Elevation de Sistólico can lead to Hipertensión , which happens in older patients
  • Hypertensive crises is an emergencia daro organo y la urgencia has un previnire el daro
  • Resistant Hypertension are when a patient has to treat with medication: es cuando el paciente tiene medicamentos

Introdution

  • High blood pressure is defined as a persistent hypertension
  • 48.5% have high blood pressure

Prevalence

  • 50% men vs 44% women
  • 56% non-Hispanic blacks
  • 48% non-Hispanic whites
  • 46% Asians
  • 39% Hispanic

High Blood Pressure: Etiology

  • Primary/essential hypertension represents most cases (unknown cause).
  • Secondary hypertension (<10% of cases) comes from kidney disease and medications tumor encima glandula acdrenal.

High Blood Pressure: Pathophysiology

  • Primary hypertension is multifactorial, involving humoral, neural, peripheral, and vascular endothelial mechanisms
  • High blood pressure can be caused because there are Disturbances -
  • The electrolitos-disturbance and the Na

Humoral

  • The heart releases humerol

  • The kidneys also contribute to high blood pressure

  • blocks active transport of Na+2 out of arteriolar. smooth muscles causes renal Na+2 retention and enhances SNS activity

Renin-Angiotensin-Aldosterone System

  • RAAS increases blood pressure, stimulates adrenal gland, Aldosterone and increases water
  • Is used when it has tension
  • ACE Converts everything

Cardiovascular: Drugs

  • Know mechanisms to control hypertension

Cardiovascular: Neutral

  • Stimulation of adrenergic receptors increases heart rate and contractility while receptors
  • Causes vasoconstriction
  • Stimulation of Beta receptors causes vasodilation, and the rest
  • Inhibits NE release

Cardiovascular: Pathophysiology

  • Peripheral causes regulation abnormalities
  • Increases
  • renal defects and sodium excretion and plasma volume expansion
  • increase blood pressure

Pathophysiology: Vascular endothelial

  • Dilates is inflamación vasodation
  • Constricts: Presión deseada = 120/80

Hypertension Complications

  • Retinal involvement
  • Coronary artery disease - causes heart failure
  • Renal and cerebrovascular
  • Htn = causes anwrisims

Hypertension: Classification

  • Aprender todas los clasificacion

Hypertensive Crises

  • Hytertensive = danno al organo

Diagnosis

  • Two of more readings on two of more different visits a screening

Evaluation

  • Known duration and levels -History can cause patient issues

  • Also lifestyle and drugs

  • Exam = Blood pressure -

    • fundoscopic exam - ojos vasos and is called av picking
  • Also lifestyle -Brazo alineada 90 Self messier blood presurre

  • Also the medication

Goals

  • Decrease to renal and
  • Sbp

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