Cardiovascular System - Week 8: Hypertension
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Questions and Answers

What is considered a primary consequence of untreated chronic hypertension?

  • Reduced blood volume
  • Decreased heart rate
  • Increased peripheral resistance
  • Kidney failure (correct)

    • Which condition is NOT commonly associated with secondary hypertension?

  • Pre-eclampsia of pregnancy
  • Adrenalectomy (correct)
  • Renal disease
  • Pheochromocytoma

    • Which factor is indicative of pre-eclampsia during pregnancy?

  • Weight gain of >5 lbs a week (correct)
  • High levels of sodium in urine
  • Elevated heart rate
  • Hypotension

    • How does decreasing vascular resistance affect blood pressure?

    <p>It reduces blood pressure (A)</p> Signup and view all the answers

    Which group has a higher risk of developing pre-eclampsia?

    <p>Teenage mothers (B), Mothers over age 35 (C)</p> Signup and view all the answers

    What physiological change is primarily responsible for left ventricular hypertrophy due to hypertension?

    <p>Increased oxygen consumption (C)</p> Signup and view all the answers

    Which symptom is characteristic of pheochromocytoma?

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

    What potential effect can chronic hypertension have on blood vessels?

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

    Which class of antihypertensive medication is known to block beta 1 and beta 2 receptors?

    <p>Non-selective beta blockers (C)</p> Signup and view all the answers

    What is a common side effect of ACE inhibitors?

    <p>Dry cough (B)</p> Signup and view all the answers

    Which medication would be contraindicated in patients with underlying kidney issues?

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

    What do calcium channel blockers primarily achieve through their action?

    <p>Decrease vascular resistance (B)</p> Signup and view all the answers

    Which of the following outcomes is associated with the use of beta blockers?

    <p>Potential for rebound hypertension (D)</p> Signup and view all the answers

    What is the primary effect of vasodilators such as minoxidil?

    <p>Decrease in blood pressure (A)</p> Signup and view all the answers

    Which antihypertensive class is least likely to cause impotence in male patients?

    <p>Calcium channel blockers (A), ACE inhibitors (B)</p> Signup and view all the answers

    What is the mechanism of action for ACE inhibitors?

    <p>Block conversion of angiotensin I to angiotensin II (C)</p> Signup and view all the answers

    Which condition is characterized by the hardening of arteries and commonly leads to myocardial ischemia?

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

    Which risk factors for cardiovascular disease are considered unmodifiable?

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

    What is the most distinguishing symptom of stable angina?

    <p>Pain relieved by rest (A)</p> Signup and view all the answers

    What laboratory test indicates myocardial injury if the CPK-MB levels are greater than 3%?

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

    What is a significant consequence of an occlusion in the left anterior descending artery?

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

    What is a common side effect of nitroglycerin used in treating angina?

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

    Which symptom is often experienced more commonly by women during myocardial ischemia?

    <p>Pain down the left arm (C)</p> Signup and view all the answers

    Which method is used to assess ST elevation and ischemia in diagnosing myocardial infarction?

    <p>12 lead ECG (D)</p> Signup and view all the answers

    Flashcards

    Secondary Hypertension

    High blood pressure caused by an underlying condition.

    Renal Disease (Hypertension)

    Kidney disease causing high blood pressure due to fluid retention.

    Pre-eclampsia

    Pregnancy complication causing high blood pressure, protein in urine, and other symptoms.

    Pheochromocytoma

    Adrenal gland tumor causing high blood pressure and other symptoms.

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    Vascular Resistance

    The opposition to blood flow in blood vessels.

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    Left Ventricular Hypertrophy

    Thickening of the heart's main pumping chamber due to strain.

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    Chronic Hypertension

    Long-term high blood pressure.

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    Complications of Untreated Hypertension

    Uncontrolled high blood pressure can lead to blood vessel damage, heart attack, heart failure, and kidney failure.

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    Beta Blockers

    Drugs that block beta receptors, which can reduce heart rate and blood pressure. They can be cardio-selective (affect only beta 1 receptors) or non-selective (affect both beta 1 and beta 2 receptors).

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    Beta Blocker Side Effects

    Potential side effects of beta-blockers include impotence in males, rebound hypertension if stopped abruptly, and suppressed glycogenolysis, which may cause low blood sugar in susceptible individuals.

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    ACE Inhibitors

    Drugs that block the conversion of angiotensin I to angiotensin II, helping reduce blood pressure and fluid retention.

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    ACE Inhibitor Side Effect

    A common side effect of ACE inhibitors is a dry cough, potentially due to the buildup of prostaglandins and bradykinins.

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    Calcium Channel Blockers

    Drugs that reduce blood pressure by decreasing calcium movement into muscle cells, slowing muscle contraction and widening blood vessels.

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    Centrally Acting Adrenergic Inhibitors

    These drugs cross the blood-brain barrier to reduce heart rate and blood pressure.

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    Vasodilators

    Drugs that decrease blood pressure by widening blood vessels, useful for severe hypertension.

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    Refractory Hypertension

    High blood pressure that is not controlled by five or more medications, including a diuretic.

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    Arteriosclerosis/Atherosclerosis

    Hardening or narrowing of the arteries, a common type; leading to lack of oxygenation to the heart muscle and potentially chest pain.

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    Angina Pectoris

    Chest pain caused by insufficient blood flow/oxygen to the heart muscle.

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    Stable Angina

    Angina that is relieved by rest or nitroglycerin.

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    Unstable Angina

    Angina that is not relieved by rest or nitroglycerin; more serious and needs immediate medical attention.

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    Myocardial Infarction

    Heart attack; death of heart muscle tissue due to lack of blood flow.

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    12-lead ECG

    A test that measures electrical activity of the heart; helps diagnose heart problems.

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    ST elevation on ECG

    Sign on ECG indicating heart muscle injury.

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    Troponin I

    A blood test used to detect heart muscle damage; elevated levels suggest a heart attack.

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    Study Notes

    Cardiovascular System - Week 8

    • 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)

    • Symptoms/Causes of Hypertension:

      • palpitations
      • sweating
      • headache
      • Adrenalectomy (surgical removal of adrenal gland) may increase or decrease stroke volume, affecting blood ejection.

    • Chronic High Blood Pressure (Hypertension):

      • Untreated hypertension can lead to blood vessel damage (arteriosclerosis), heart attack, and/or heart failure, and kidney failure.

    • Physiological Control of BP in Hypertension

    • 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)

    • 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

    • 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.

    • 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)

    • 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)

    • 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)

    • Stress Test:

      • Monitors heart response to physical activity, and emotional strain.

    • 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

    • 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)

    • 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)

    • 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)

    • 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.

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