Podcast
Questions and Answers
What is considered a primary consequence of untreated chronic hypertension?
What is considered a primary consequence of untreated chronic hypertension?
Which condition is NOT commonly associated with secondary hypertension?
Which condition is NOT commonly associated with secondary hypertension?
Which factor is indicative of pre-eclampsia during pregnancy?
Which factor is indicative of pre-eclampsia during pregnancy?
How does decreasing vascular resistance affect blood pressure?
How does decreasing vascular resistance affect blood pressure?
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Which group has a higher risk of developing pre-eclampsia?
Which group has a higher risk of developing pre-eclampsia?
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What physiological change is primarily responsible for left ventricular hypertrophy due to hypertension?
What physiological change is primarily responsible for left ventricular hypertrophy due to hypertension?
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Which symptom is characteristic of pheochromocytoma?
Which symptom is characteristic of pheochromocytoma?
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What potential effect can chronic hypertension have on blood vessels?
What potential effect can chronic hypertension have on blood vessels?
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Which class of antihypertensive medication is known to block beta 1 and beta 2 receptors?
Which class of antihypertensive medication is known to block beta 1 and beta 2 receptors?
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What is a common side effect of ACE inhibitors?
What is a common side effect of ACE inhibitors?
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Which medication would be contraindicated in patients with underlying kidney issues?
Which medication would be contraindicated in patients with underlying kidney issues?
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What do calcium channel blockers primarily achieve through their action?
What do calcium channel blockers primarily achieve through their action?
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Which of the following outcomes is associated with the use of beta blockers?
Which of the following outcomes is associated with the use of beta blockers?
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What is the primary effect of vasodilators such as minoxidil?
What is the primary effect of vasodilators such as minoxidil?
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Which antihypertensive class is least likely to cause impotence in male patients?
Which antihypertensive class is least likely to cause impotence in male patients?
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What is the mechanism of action for ACE inhibitors?
What is the mechanism of action for ACE inhibitors?
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Which condition is characterized by the hardening of arteries and commonly leads to myocardial ischemia?
Which condition is characterized by the hardening of arteries and commonly leads to myocardial ischemia?
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Which risk factors for cardiovascular disease are considered unmodifiable?
Which risk factors for cardiovascular disease are considered unmodifiable?
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What is the most distinguishing symptom of stable angina?
What is the most distinguishing symptom of stable angina?
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What laboratory test indicates myocardial injury if the CPK-MB levels are greater than 3%?
What laboratory test indicates myocardial injury if the CPK-MB levels are greater than 3%?
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What is a significant consequence of an occlusion in the left anterior descending artery?
What is a significant consequence of an occlusion in the left anterior descending artery?
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What is a common side effect of nitroglycerin used in treating angina?
What is a common side effect of nitroglycerin used in treating angina?
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Which symptom is often experienced more commonly by women during myocardial ischemia?
Which symptom is often experienced more commonly by women during myocardial ischemia?
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Which method is used to assess ST elevation and ischemia in diagnosing myocardial infarction?
Which method is used to assess ST elevation and ischemia in diagnosing myocardial infarction?
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Study Notes
Cardiovascular System - Week 8
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Hypertension:
- 5 liters of blood per minute flow
- Silent killer—often undetected until stroke
- Secondary hypertension - caused by other conditions
- Renal disease can cause hypertension
- Holding fluids, elevated blood pressure
- Teenage mothers and individuals over 35 are at risk for hypertension with weight gain over 5 lbs a week and swelling of extremities, headaches, and elevated blood pressure.
- Protein in urine indicates nephropathy (kidney damage) with reduced renal function; usually small amounts
- Pheochromocytoma: benign tumor on adrenal gland, secreting catecholamines (norepinephrine, epinephrine)
Cardiovascular System - Week 8 (Continued)
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Symptoms/Causes of Hypertension:
- palpitations
- sweating
- headache
- Adrenalectomy (surgical removal of adrenal gland) may increase or decrease stroke volume, affecting blood ejection.
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Chronic High Blood Pressure (Hypertension):
- Untreated hypertension can lead to blood vessel damage (arteriosclerosis), heart attack, and/or heart failure, and kidney failure.
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Physiological Control of BP in Hypertension
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Antihypertensive Therapy:
- Beta-blockers (end in "olol"): non-selective (block beta-1 and beta-2 receptors) and cardio-selective (block only beta-1 receptors); non-selective beta-blockers are not recommended for male patients as they can cause impotence.
- Beta-blockers can also cause rebound hypertension and/or hemorrhagic stroke if stopped.
- ACE inhibitors (end in "pril"): block conversion of angiotensin I to angiotensin II, which prevents release of aldosterone, reducing water and sodium retention; possible side effect of dry cough
- Calcium channel blockers lower vascular resistance by slowing calcium movement in cells, leading to decreased muscle contraction.
Cardiovascular System - Week 8 (Continued)
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Centrally Acting Adrenergic Inhibitors:
- These drugs pass the blood-brain barrier to decrease heart rate and blood pressure, with possible side effects like fluid and sodium retention
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Vasodilators:
- Increase arterial diameter, reducing blood pressure and slowing electrical conduction to decrease heart rate.
- Effective treatment in patients with severe hypertension that remains uncontrolled by multiple drugs, especially in combination with diuretics.
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Acute Issues:
- Nitroprusside intravenously administered medication used to rapidly lower blood pressure and prevent a hemorrhagic stroke.
- 200/120 mmHg Blood pressure levels: The medication affects blood pressure, and higher readings may require more medication dose adjustments to lower the blood pressure.
Cardiovascular System - Week 8 (Continued)
-
Arteriosclerosis (Atherosclerosis):
- Hardening of arteries - a common type, most commonly leads to myocardial ischemia, chest pain (more common in males), and additional symptoms (left arm pain) in women.
- The tunica intima thickens in men post-menopause and is associated with loss of estrogen and other unmodifiable risk factors (age, gender, genetics), and modifiable risk factors.
Cardiovascular System - Week 8 (Continued)
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Angina Pectoris:
- Insufficient blood/oxygen — lactic acid buildup causes chest pain
- Stable angina: relieved by rest and nitroglycerin
- Unstable angina: not relieved by rest; more serious and requires evaluation, new signs and symptoms -Treatment involves morphine, oxygen supplementation, and sublingual nitroglycerin.
Cardiovascular System - Week 8 (Continued)
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Myocardial Infarction (Heart Attack):
- Occurs on the left side of the heart, most commonly in the left anterior descending (LAD) artery, leading to severe heart attack.
- Diagnosis includes 12-lead ECG, with ST elevation (heart injury) or ST depression (ischemia), and deep, wide Q waves (pathological infarction).
- Laboratory tests for MI include CPK-MB (greater than 3%), Troponin I (less than 0.04 ng/mL), and Troponin T (less than 0.01 ng/mL); their elevation suggests heart muscle damage.
Cardiovascular System - Week 8 (Continued)
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Stress Test:
- Monitors heart response to physical activity, and emotional strain.
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Drugs During Heart Disease:
- ASA (Aspirin): decreases platelet aggregation, preventing clot formation
- Lipid-lowering drugs (e.g., lovastatin, other "statins"): decrease cholesterol and LDL levels
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Complications of Medication:
- Statins with ciprofloxacin or levofloxacin: a decrease in statin dose is needed; liver damage is a significant complication.
- Rhabdomyolysis (breakdown of skeletal muscle): a rare but possible complication of some medications, especially in individuals with impaired kidney function.
Cardiovascular System - Week 8 (Continued)
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Vasodilators (Continued):
- Nitroglycerin (sublingual): used for angina pain relief; do not exceed 3 tablets in a 5-minute interval. Immediate 911 call is indicated or required for second tablet.
- Other vasodilators, such as calcium channel blockers (dilate coronary arteries, reduce oxygen demand) and beta-blockers (lower heart rate and contractility) are also important in managing hypertension and other cardiovascular conditions.
Cardiovascular System - Week 8 (Continued)
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Coronary Artery Bypass Graft (CABG):
- Surgical procedure to restore blood flow to the heart muscle, using saphenous vein or mammary artery for bypass grafting.
- Relieves angina and prolongs life.
Cardiovascular System - Week 8 (Continued)
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Heart Failure:
- Hypertension and hypertrophy of the left ventricle lead to less effective relaxation between heartbeats.
- Myocardial infarction, alcohol abuse, and cocaine abuse can cause heart failure.
- Treatment includes diuretics (reduce venous and arterial pressure), angiotensin-aldosterone system suppressors (including ACE inhibitors), cardiac glycosides (e.g., digoxin), and/or angiotensin receptor blockers to address heart failure.
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Description
This quiz covers key concepts related to hypertension, including its causes, symptoms, and implications for health. Students will explore how hypertension can be a silent killer and the importance of recognizing risk factors and related conditions. Understanding the impact of renal disease and adrenal issues will also be assessed.
