drug regimen for hypertension correct answers -initiated using single drug at low dose
-diuretic recommended as initial drug of choice
-Dose is slowly increased until optimal BP control achieved
-if drug tolerated well but BP not controlled second drug may be added to achieve desired goal
-If drug does not effectively lower BP, different drug from another class is substituted
-treatment of stage II more aggressive
-immediate therapy vital if average BP > 200/120 mmHg
-one year of effective control, effort made to reduce dosage or number of drugs; this is "step-
down" therapy
average systolic pressure in health adults correct answers <120mmHg
average diastolic pressure in healthy adults correct answers <80mmHg
Peripheral vascular resistance correct answers opposing forces or impedance to blood flow
peripheral vascular resistance determined by three factors correct answers blood viscosity
length of the vessel
diameter of the vessel
factors influencing arterial blood pressure correct answers -sympathetic nervous system
stimulation
-circulating epinephrine and norepinephrine
-renin-angiotensin-aldosterone system
-atrial natriuretic peptide
-adrenomedullin
, -vasopressor or antidiuretic hormone
-local factors
-extent of hardening of the arteries and plaque accumulation
-factors affecting blood flow, peripheral vascular resistance, and blood pressure (sympathetic and
parasympathetic nervous systems, baroreceptors and chemoreceptors in the aortic arch, carotid
sinus, and other large vessels, kidneys, temperature, diet, race, gender, age, weight ,time of day,
position, exercise, emotional state)
primary hypertension correct answers persistently elevated systemic blood pressure
develops through interaction between
-overstimulation of alpha- and beta- adrenergic receptors
-altered function of the renin-angiotensin-aldosterone system
-other chemical mediators of blood volume and vasomotor tone
-interaction among insulin resistance, hyperinsulinemia, and endothelial function
Result of interaction: sustained increases in blood volume, PVR
-Cardiovascular system reacts by increasing CO
-Autoregulatory mechanisms react, causing hypertension
secondary hypertension correct answers elevated blood pressure from an identified cause such as
-kidney disease
-coarctation of the aorta
-endocrine disorders
-neurological disorders
-drug use
-pregnancy
-hypothyroidism
-obstructive sleep apnea