Podcast
Questions and Answers
What is the definition of blood pressure?
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 the pressure in the artery during the ventricular contraction phase of the heart cycle?
What is a complication of hypertension?
What is a complication of hypertension?
What is the pressure in the artery when the ventricles are relaxed?
What is the pressure in the artery when the ventricles are relaxed?
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What is hypertension?
What is hypertension?
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What can hypertension cause to the vessel walls?
What can hypertension cause to the vessel walls?
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What happens to blood pressure during physical exertion or stressful moments?
What happens to blood pressure during physical exertion or stressful moments?
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What is the effect of smoking on blood vessels?
What is the effect of smoking on blood vessels?
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What is ionotropic?
What is ionotropic?
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What is hypertension defined as?
What is hypertension defined as?
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What is a complication of hypertension?
What is a complication of hypertension?
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What is the effect of caffeine on blood vessels?
What is the effect of caffeine on blood vessels?
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What is the main characteristic of primary hypertension?
What is the main characteristic of primary hypertension?
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Which of the following organizations has guidelines for blood pressure levels?
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?
What happens to blood vessels over time due to hypertension?
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What is a characteristic of hypertension?
What is a characteristic of hypertension?
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Why should blood pressure readings be taken on both arms?
Why should blood pressure readings be taken on both arms?
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What is the primary cause of secondary hypertension?
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?
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?
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?
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?
What is a characteristic of Masked Hypertension?
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What is an independent risk marker for the new development of Hypertension?
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?
What is associated with an increased risk of stroke?
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What condition is associated with elevated blood triglycerides?
What condition is associated with elevated blood triglycerides?
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What is a characteristic of White Coat Hypertension?
What is a characteristic of White Coat Hypertension?
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What is a consequence of high serum creatinine levels?
What is a consequence of high serum creatinine levels?
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What is a risk factor for Hypertension?
What is a risk factor for Hypertension?
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What is the main purpose of a dipstick urine test in hypertension?
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?
Which of the following tests is used to detect left ventricular hypertrophy?
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What is the significance of hemoglobin in hypertension?
What is the significance of hemoglobin in hypertension?
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Why is serum uric acid test used in hypertension?
Why is serum uric acid test used in hypertension?
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What is the function of the right ventricle in the heart?
What is the function of the right ventricle in the heart?
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What is the purpose of fundoscopy in hypertension?
What is the purpose of fundoscopy in hypertension?
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What is a common cardiovascular risk factor in hypertension patients?
What is a common cardiovascular risk factor in hypertension patients?
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What is the significance of carotid ultrasound in hypertension?
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.
