Podcast
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?
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?
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?
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?
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?
Which statement accurately describes the interaction between cardiac output (CO) and total peripheral resistance (TPR) in determining blood pressure (BP)?
Which statement accurately describes the interaction between cardiac output (CO) and total peripheral resistance (TPR) in determining blood pressure (BP)?
Which statement accurately describes the role of natriuretic hormones in blood pressure regulation?
Which statement accurately describes the role of natriuretic hormones in blood pressure regulation?
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?
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?
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?
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?
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?
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?
Which of the following statements accurately describes the current understanding of the role of genetics in the pathogenesis of essential hypertension?
Which of the following statements accurately describes the current understanding of the role of genetics in the pathogenesis of essential hypertension?
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?
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?
Which of the following statements accurately portrays the influence of dietary sodium intake on blood pressure regulation, particularly in salt-sensitive individuals?
Which of the following statements accurately portrays the influence of dietary sodium intake on blood pressure regulation, particularly in salt-sensitive individuals?
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?
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?
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?
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?
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?
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?
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?
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?
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?
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?
Compared to arteries, which statement is accurate about the structure and function of veins?
Compared to arteries, which statement is accurate about the structure and function of veins?
Which is a known modifiable risk factor for CVD?
Which is a known modifiable risk factor for CVD?
How would you describe the influence of genetics, race, age, obesity, diet/sodium intake and alcohol consumption on the development of hypertension?
How would you describe the influence of genetics, race, age, obesity, diet/sodium intake and alcohol consumption on the development of hypertension?
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?
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?
What causes Primary or Essential HTN?
What causes Primary or Essential HTN?
Which statement best describes the cascade of the Renin-Angiotensin-Aldosterone System (RAAS)?
Which statement best describes the cascade of the Renin-Angiotensin-Aldosterone System (RAAS)?
How do Beta-1 adrenergic receptors impact blood pressure??
How do Beta-1 adrenergic receptors impact blood pressure??
Which of the following statements BEST describes the primary mechanism by which increased dietary potassium intake lowers blood pressure?
Which of the following statements BEST describes the primary mechanism by which increased dietary potassium intake lowers blood pressure?
Which of the following lipid profile patterns would be considered the MOST atherogenic and predictive of cardiovascular events in patients with hypertension?
Which of the following lipid profile patterns would be considered the MOST atherogenic and predictive of cardiovascular events in patients with hypertension?
Which of the following best describes the blood pressure classification for Hypertensive Urgency?
Which of the following best describes the blood pressure classification for Hypertensive Urgency?
What is the MOST accurate method of measuring or evaluating hypertension?
What is the MOST accurate method of measuring or evaluating hypertension?
Which of the following is the most important goal for a patient being diagnosed with hypertension?
Which of the following is the most important goal for a patient being diagnosed with hypertension?
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?
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?
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?
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?
Which of the following lifestyle modifications would have the greatest impact on SBP if implemented?
Which of the following lifestyle modifications would have the greatest impact on SBP if implemented?
What is the clinical recommendation for alcohol consumption in a hypertensive patient?
What is the clinical recommendation for alcohol consumption in a hypertensive patient?
According to the referenced slide content, what does BP equal?
According to the referenced slide content, what does BP equal?
Which is not a risk factor for cardiovascular disease?
Which is not a risk factor for cardiovascular disease?
A 60 year old smoker is diagnosed with heart disease, what is the next step?
A 60 year old smoker is diagnosed with heart disease, what is the next step?
If the body released Anti-Diuretic hormone (ADH), what would happen to the patient's blood pressure?
If the body released Anti-Diuretic hormone (ADH), what would happen to the patient's blood pressure?
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?
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?
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?
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?
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?
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?
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?
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?
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?
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?
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?
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?
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?
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?
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?
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?
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?
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?
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?
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?
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?
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?
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?
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?
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?
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?
Which of the following best explains the mechanism for Blood Pressure reduction via the DASH diet?
Which of the following best explains the mechanism for Blood Pressure reduction via the DASH diet?
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?
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?
Flashcards
Cardiovascular Diseases (CVD)
Cardiovascular Diseases (CVD)
A disease class that involves the heart and blood vessels.
Arterial Blood Pressure
Arterial Blood Pressure
Increased pressure in the arteries, exerting force as blood passes through.
Systolic Blood Pressure (SBP)
Systolic Blood Pressure (SBP)
The peak pressure in the arteries during heart muscle contraction.
Diastolic Blood Pressure (DBP)
Diastolic Blood Pressure (DBP)
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Pulse Pressure
Pulse Pressure
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Mean Arterial Pressure (MAP)
Mean Arterial Pressure (MAP)
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Hypertension (HTN)
Hypertension (HTN)
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Cardiovascular diseases
Cardiovascular diseases
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Cardiovascular diseases
Cardiovascular diseases
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Atherosclerosis
Atherosclerosis
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Coronary Artery Disease (CAD)
Coronary Artery Disease (CAD)
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MI/Angina
MI/Angina
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Arrhythmias
Arrhythmias
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Heart Failure (HF)
Heart Failure (HF)
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Cerebrovascular Disease (Stroke)
Cerebrovascular Disease (Stroke)
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Peripheral Vascular Disease
Peripheral Vascular Disease
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Congenital Heart Disease
Congenital Heart Disease
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Rheumatic Heart Disease
Rheumatic Heart Disease
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Risk Factors for CVD
Risk Factors for CVD
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Age
Age
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Race
Race
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Gender
Gender
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Postmenopausal Status
Postmenopausal Status
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Family History
Family History
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Hypertension (HTN)
Hypertension (HTN)
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Diabetes Mellitus (DM)
Diabetes Mellitus (DM)
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Dyslipidemia
Dyslipidemia
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Smoking
Smoking
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Obesity
Obesity
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Physical Inactivity
Physical Inactivity
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Excessive Alcohol
Excessive Alcohol
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Illicit Drug Use
Illicit Drug Use
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Stress
Stress
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Chronic Inflammation
Chronic Inflammation
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Arterial blood pressure
Arterial blood pressure
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Systolic Pressure
Systolic Pressure
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Diastolic Pressure
Diastolic Pressure
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Elevated Systemic Blood Pressure
Elevated Systemic Blood Pressure
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Blood Pressure Reading
Blood Pressure Reading
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White-Coat Hypertension
White-Coat Hypertension
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Isolated systolic hypertension
Isolated systolic hypertension
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Hypertensive Emergency
Hypertensive Emergency
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Hypertensive Urgency
Hypertensive Urgency
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Resistant Hypertension
Resistant Hypertension
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Hypertension
Hypertension
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Incidence/Prevalence Increase
Incidence/Prevalence Increase
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Secondary Hypertension
Secondary Hypertension
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Primary HTN Mechanisms
Primary HTN Mechanisms
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Humoral Mechanism
Humoral Mechanism
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RAAS
RAAS
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BP Treatment Goal
BP Treatment Goal
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Goal in Managing HTN
Goal in Managing HTN
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Strategies to achieve optimal BP
Strategies to achieve optimal BP
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Lifestyle Modifications
Lifestyle Modifications
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Lifestyle Modifications
Lifestyle Modifications
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Study Notes
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Cardiovascular diseases include hypertension
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A stroke is the same as apoplegia
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Isquemia is greater than hemorragic
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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
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Age is greater with incidence
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Race :Raza negra
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Corticosteroia protegen y ya no estin during gender
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Gender is Male greater than Female until menopause
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Famale is greater than male ater la manopausia
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People on Postmenopausal status are at more risk
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Also, Family History, HTN, DM, Hyperlipidemia
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Triada =
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Hyperlipidemia = Hipertensión
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People with detrimental smoking, activo y pasivo are at greater risk
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Obesity can increased health risk BMI >30
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Physical inclativity
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Alcohol moderado it ok Pen ei uso crónico es malo
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Excessive Alcohol
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Illicit drug use cocaina, heroina
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People with Stress
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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
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Pre-charge increases with increase TPR needs fuerza SÃstole for sacarla
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For lower heart rate one need periferical and diminue TPR
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SÃstole can be controlled vasodilation and the reverse
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Pre-charge = return of sangre
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During the aumeto de TPR, you will need fuerza extra for vencer Diástole
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You need carga -
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fuerza de contracción SÃstole
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sangre - aorta
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Sangre acumulada ejerce fuerza en ventrÃculo diastole
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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
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The heart releases humerol
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The kidneys also contribute to high blood pressure
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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
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Known duration and levels -History can cause patient issues
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Also lifestyle and drugs
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Exam = Blood pressure -
- fundoscopic exam - ojos vasos and is called av picking
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Also lifestyle -Brazo alineada 90 Self messier blood presurre
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Also the medication
Goals
- Decrease to renal and
- Sbp
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