Questions and Answers
What is the definition of blood pressure?
What is the pressure in the artery during the ventricular contraction phase of the heart cycle?
What is a complication of hypertension?
What is the pressure in the artery when the ventricles are relaxed?
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What is hypertension?
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What can hypertension cause to the vessel walls?
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What happens to blood pressure during physical exertion or stressful moments?
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What is the effect of smoking on blood vessels?
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What is ionotropic?
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What is hypertension defined as?
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What is a complication of hypertension?
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What is the effect of caffeine on blood vessels?
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What is the main characteristic of primary hypertension?
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Which of the following organizations has guidelines for blood pressure levels?
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What happens to blood vessels over time due to hypertension?
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What is a characteristic of hypertension?
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Why should blood pressure readings be taken on both arms?
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What is the primary cause of secondary hypertension?
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What is the normal blood pressure category defined by the 2017 AHA/ACC guidelines?
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How many readings are recommended to determine blood pressure levels?
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What type of blood pressure monitoring is recommended when there is diagnostic uncertainty or suspected blood pressure variability?
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What is a characteristic of Masked Hypertension?
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What is an independent risk marker for the new development of Hypertension?
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What is associated with an increased risk of stroke?
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What condition is associated with elevated blood triglycerides?
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What is a characteristic of White Coat Hypertension?
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What is a consequence of high serum creatinine levels?
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What is a risk factor for Hypertension?
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What is the main purpose of a dipstick urine test in hypertension?
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Which of the following tests is used to detect left ventricular hypertrophy?
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What is the significance of hemoglobin in hypertension?
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Why is serum uric acid test used in hypertension?
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What is the function of the right ventricle in the heart?
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What is the purpose of fundoscopy in hypertension?
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What is a common cardiovascular risk factor in hypertension patients?
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What is the significance of carotid ultrasound in hypertension?
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Study Notes
Blood Pressure
- Blood pressure is the force of blood exerting against the walls of blood vessels, which can cause damage to vessel walls due to irritation of the inner layer.
- Systolic pressure is the pressure in the artery during ventricular contraction, while diastolic pressure is the pressure in the artery when the ventricles are relaxed.
Factors Affecting Blood Pressure
- Physical exertion and stressful moments can increase blood pressure.
- Age can decrease elasticity, making blood vessels stiffer, which increases blood pressure.
- Smoking can make blood more viscous, leading to scarring and increased blood pressure.
- Alcohol can stimulate the sympathetic nervous system, increasing blood pressure.
- Caffeine can constrict blood vessels, causing the heart to pump harder and increasing blood pressure.
Hypertension Definition
- Hypertension is defined as consistently elevated blood pressure, specifically:
- Elevated systolic pressure (≥140 mm Hg) and/or
- Elevated diastolic pressure (≥90 mm Hg)
Hypertension Complications
- Coronary artery disease (CAD)
- Heart failure
- Chronic kidney disease
- Stroke
- Intracerebral hemorrhage
- Transient ischemic attack (TIA)
- Peripheral artery disease (PAD)
- Aortic regurgitation
- Atrial flutter
Types of Hypertension
- Primary (essential) hypertension: high blood pressure not resulting from a medical condition, due to environmental and genetic factors.
- Secondary hypertension: abnormally elevated blood pressure due to a medical condition or use of certain medicines.
Classification and Measurement
- Blood pressure levels should be based on an average of 2-3 readings on repeated measurements.
- Different professional organizations have varying definitions of hypertension.
- Ambulatory blood pressure monitoring (ABPM) and home blood pressure monitoring can be used to confirm diagnosis.
- Masked hypertension: elevated blood pressure at home/ambulatory BP monitoring but normal office blood pressure.
- White coat hypertension: normal blood pressure at home/ambulatory BP monitoring but elevated office blood pressure.
Additional Testing
- Blood tests: sodium, potassium, creatinine, fasting blood glucose, fasting lipid profile.
- High sodium intake (>2 g/day) is associated with higher blood pressure.
- Low dietary potassium intake (<40 mEq/day) is associated with elevated blood pressure and increased risk of stroke.
- Higher creatinine levels are associated with chronic renal disease.
- Higher fasting blood glucose levels are an independent risk marker for new development of hypertension.
- Cardiovascular disease is associated with hypertension and increased blood levels of LDL, total cholesterol, and triglycerides.
Other Tests to Consider
- Dipstick urine test for proteinuria.
- Electrocardiogram (ECG) for detection of atrial fibrillation, left ventricular hypertrophy, and ischemic heart disease.
- Hemoglobin/hematocrit for oxygen carrying capacity.
- Serum uric acid for decreased renal blood flow.
- Echocardiogram for left ventricular hypertrophy and structural heart disease.
- Fundoscopy for retinal changes, hemorrhages, papilledema, tortuosity, and AV-nicking.
- Carotid ultrasound for plaques and stenosis.
- Targeted testing for suspected causes of secondary hypertension.
Blood Pressure Targets and Cardiovascular Risk Factors
- Blood pressure targets vary depending on the organization.
- As age increases, blood pressure targets also increase due to high fall risk.
- >50% of hypertensive patients have additional cardiovascular risk factors, including diabetes, lipid disorders, hypothyroidism, overweight-obesity, hyperuricemia, and metabolic syndrome.
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Description
This lecture covers the definition, incidence, prevalence, risk factors, types, symptoms, pathophysiology, complications, and treatment options of hypertension.
