Term
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Definition
| Persistently elevated arterial blood pressure |
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Term
| What are the two broad categories of HTN? |
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Definition
Primary (idiopathic or essential)
and Secondary |
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Term
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Definition
| Cause is unknown; occurs in over 95% of patients with hypertension |
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Term
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Definition
| Cause is attributed to a specific disease or drug therapy; occurs in less than 5% of patients with hypertension |
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Term
| What are the two numbers in a blood pressure measurement? |
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Definition
Systolic pressure- cardiac contraction
Diastolic pressure- phase after contraction |
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Term
| During a day, when are the highest BP average values? |
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Definition
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Term
| Give the equation to define blood pressure |
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Definition
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Term
| What happens when central α2-adrenergic receptors are stimulated? |
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Definition
| Lowers blood pressure by inhibiting the vasomotor center (e.g., clonidine and methyldopa). |
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Term
| What happens when post-synaptic α1-receptors on arterioles and venules are stimulated? |
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Definition
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Term
| What happens when post-synaptic beta2-receptors on arterioles and venules are stimulated? |
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Definition
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Term
| What happens when pre-synaptic α2-receptors are stimulated? |
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Definition
| Norepinephrine is released from the nerve terminus |
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Term
| What happens when pre-synaptic beta-receptors are stimulated? |
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Definition
| Norepinephrine is released from the nerve terminus |
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Term
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Definition
| Nerve endings within the walls of large arteries such as the carotid arteries and the aortic arch. |
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Term
| How do local tissues autoregulate blood flow to maintain adequate oxygenation for metabolic processes? |
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Definition
| When oxygen demand is high, local arteriolar beds vasodilate to increase blood flow and thus oxygen supply. When oxygen demand is low, local arteriolar beds remain relatively vasoconstricted. |
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Term
| What would happen if there was a defect in the renal autoregulatory system that causes increased fluid volume and thus increased blood flow and oxygen delivery to local tissues? |
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Definition
Local tissue autoregulatory mechanism of vasoconstriction.
Sustained vasoconstriction in arteriolar beds would lead to sustained increases in total peripheral resistance. |
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Term
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Definition
renin-angiotensin-aldosterone system
an important role in regulating sodium, potassium, fluid balance, sympathetic nervous system activity, and vascular tone. |
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Term
Define renin
Where is it stored? |
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Definition
Renin catalyzes the conversion of angiotensinogen to angiotensin
Renin is synthesized and stored in the juxtaglomerular cells located in the media of the renal afferent arterioles |
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Term
| Define juxtaglomerular apparatus |
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Definition
| The juxtaglomerular cells and specialized distal tubule cells |
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Term
| What stimulates renin release? |
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Definition
a. decreased renal perfusion pressure
b. decrease in the amount of sodium and chloride delivered to the distal tubule of the nephron (detected by the macula densa)
c. direct stimulation of the juxtaglomerular apparatus by catecholamines
d. decreased circulating levels of angiotensin II |
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Term
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Definition
| angiotensin converting enzyme, converts angiotensin I to angiotensin II |
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Term
| What is the effect of angiotensin II |
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Definition
Angiotensin II stimulates angiotensin II-type 1 receptors (AT1) (there may be other angiotensin II receptors with different functions) located in the brain, kidney, heart, vasculature, and adrenal tissue
This leads to vasoconstriction, catecholamine release, sympathetic activity, and aldosterone release |
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Term
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Definition
| An adrenal hormone that causes sodium and water retention in the distal tubule of the nephron in the kidney ultimately resulting in increased blood pressure |
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Term
| What is the effect of natriuretic hormone? |
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Definition
| Nuretic hormone is believed to block active transport of sodium out of arteriolar smooth muscle cells leading ultimately to increased vascular tone and thus elevated blood pressure. |
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Term
| What is the effect of insulin on blood pressure? |
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Definition
a. increase sodium and water retention in the kidney
b. lead to enhanced sympathetic nervous system activity
c. cause hypertrophy of arteriolar smooth muscle
d. increase intracellular calcium concentrations in the smooth muscle cells of the vasculature leading to increased TPR |
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Term
| List 3 vascular vasodilating substances |
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Definition
| prostacyclin and bradykinin, nitric oxide |
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Term
| List two vascular vasoconstricting substances |
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Definition
| angiotensin II and endothelin I |
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Term
| How does dietary sodium affect BP? |
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Definition
a. Dietary sodium intake is linked to hypertension.
b. The exact mechanism of this effect is not known but excessive sodium intake may be linked to an increase in circulating natriuretic hormone.
c. Reduced sodium intake lowers blood pressure in many patients. |
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Term
| How does dietary calcium affect BP? |
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Definition
a. Dietary deficiencies of calcium may lead to altered calcium homeostasis with a resulting relative increase intracellularly.
b. Increased intracellular calcium in small muscle cells in arteriolar walls leads to relative vasoconstriction and thus increased peripheral vascular resistance.
c. Dietary calcium supplementation reduces blood pressure slightly in some patients. |
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Term
| How does dietary potassium affect BP? |
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Definition
| Poor dietary intake is associated with increased peripheral vascular resistance. |
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Term
| List 7 diseases that can cause hypertension |
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Definition
1. Renovascular disease
2. Pheochromocytoma (adrenal tumors)
3. Primary aldosteronism
4. Cushing's disease
5. Coarctation of aorta
6. Sleep apnea
7. Head injury/brain tumors |
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Term
| List 11 drugs that can cause hypertension |
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Definition
1. estrogens
2. corticosteroids
3. NSAIDs
4. Cyclosporine
5. Decongesants, anorexiants
6. Thyroid hormone in excess
7. Ethanol
8. Ephedra
9. Venlafaxine
10. Erythropoietin
11. MAOIs |
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Term
| Describe cerebrovascular problems that can result from long-term hypertension |
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Definition
a. Strokes are one of the most common causes of death in hypertensive patients.
b. Transient ischemic attacks result from atherosclerotic disease in the carotid arteries. |
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Term
| Describe cardiac problems that can result from long-term hypertension |
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Definition
a. Left ventricular hypertrophy
b. Heart failure
c. Coronary heart disease |
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Term
| Describe renal problems that can result from long-term hypertension |
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Definition
a. Nephrosclerosis, secondary to accelerated arteriosclerosis, is the primary renal complication in hypertensive patients.
b. Hypertension is one of the leading causes of end-stage renal disease especially in African-American, Hispanic, and Native American patients |
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Term
| Describe eye problems that can result from long-term hypertension |
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Definition
a. Retinopathy is due to accelerated arteriosclerosis in retinal arteries in hypertensive patients.
b. Manifestations include focal arteriolar narrowing, retinal infarcts, and flame-shaped hemorrhages.
c. Papilledema - a swelling of the optic disk that indicates severe hypertension and the need for emergency treatment of blood pressure. |
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Term
| Describe peripheral vascular problems that can result from long-term hypertension |
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Definition
a. Peripheral vascular disease results from accelerated atherosclerosis.
b. Atherogenesis is accelerated in hypertensive patients and results in proliferation of smooth muscle cells, lipid infiltration in the vascular endothelium, and accumulation of calcium in the vasculature. |
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