Exam 3
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1. primary hypertension essential or idiopathic HTN; the
primary disease in question
*accounts for 95% of all cases of
HTN
*estimated that ¼ of the US popu-
lation has primary HTN
2. secondary hypertension HTN that is secondary to a prima-
ry disease
3. secondary hypertension of renal origin · chronic renal disease
· renal artery stenosis (“ blood flow
to kidneys makes them think sys-
temic BP is low ’ activate RAAS)
4. secondary hypertension of endocrine · adrenocortical hyperfunction
origin · hyperthyroidism
· pregnancy-induced (temporary)
5. secondary hypertension of hemody- · hypervolemia
namic / cardiovascular origin · rigidity of aorta
· coarctation of aorta
6. secondary hypertension of neurologic · ‘ intracranial pressure
origin · sleep apnea
7. major risk factors for hypertension · family hx
· age (‘ with age)
· gender (males younger than 55
y/o, women older than 74 y/o)
· race (‘ in African Americans)
· high dietary Na intake
· mineral deficiencies (K, Ca, Mg)
· DM (chronic endothelial dam-
age)
· smoking (chronic endothelial
damage)
· obesity (chronic endothelial
, Exam 3
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damage)
· heavy ETOH consumption
· stress
8. true or false: Hypertension is a normal false
sign of aging.
Rationale: HTN is not a normal
sign of aging, although increased
age is a risk factor. If HTN does oc-
cur in older age (from hardening of
arteries), most pt's exhibit isolated
systolic HTN.
9. Why is it thought that African Ameri- a difference in the body's sensitiv-
cans are at increased risk for hyperten- ity to Na
sion & CVD?
10. 3 genetically linked physiological alter- 1. defects in renal Na homeostasis
ations that may lead to the develop- 2. functional vasoconstriction (‘
ment of primary hypertension sensitivity to circulating vasocon-
strictors)
3. defects in vascular smooth
muscle growth
11. How would a defect in renal Na home- inadequate Na excretion ’ Na /
ostasis lead to primary hypertension? H2O retention ’ ‘ plasma / ECF vol-
ume ’ ‘ CO ’ HTN
*exacerbated by ‘ Na intake
*‘ plasma / ECF volume also caus-
es ‘ release of natriuretic hormone
’ ‘ sensitivity to circulating vasocon-
strictors
12. natriuretic hormone hormone secreted by the atria of
the heart that decreases Na reten-
tion by the kidney
*opposes the effect of aldosterone
, Exam 3
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13. How would functional vasoconstric- ‘ sensitivity to circulating vasocon-
tion lead to primary hypertension? strictors ’ ‘ TPR ’ HTN
14. How would a defect in vascular smooth ‘ vascular wall thickness ’ ‘ TPR ’
muscle growth lead to primary hyper- HTN
tension?
*sensitivity to circulating vasocon-
strictors also increases (potentiat-
ed by ‘ vascular wall thickness and
vice-versa)
15. What 2 ethnic/racial groups seem to · African-Americans
be similar in their increased risk for ·?
primary hypertension?
16. white coat hypertension phenomenon observed in the clin-
ical setting where pt's experience
a level of anxiety that causes their
BP to become elevated
*a "false positive" high BP reading
*opposite of masked HTN
17. masked hypertension phenomenon where a pt with
chronic HTN exhibits a lower BP
in the clinical setting
*a "false negative" healthy BP
reading
*opposite of white coat HTN
*thought to possibly be due to the
calm of a clinic office vs. the stress
of everyday life outside the clinical
setting
18. How do we screen someone for white 24-hr ambulatory BP monitoring
coat and masked hypertension?
used to calculate:
· avg 24-hr BP
, Exam 3
Study online at https://quizlet.com/_95671u
· avg waking BP
· avg nighttime BP
19. left ventricular hypertrophy (LVH) a cardiac condition in which the
left ventricle becomes enlarged
*most commonly due to HTN
(sometimes called "hypertensive
hypertrophy")
*a fairly early adaptation to chron-
ic HTN
*measured using sonography
("echo")
20. How can hypertension cause LVH? a chronically elevated afterload
requires stronger myocardium in
order to ‘ force of ventricular con-
traction
21. afterload the force of resistance against
which the heart pumps
22. preload degree of stretch of the cardiac
muscle fibers at the end of dias-
tole
*R/T volume of filling
23. wall tension the force needed to generate a
particular ventricular pressure at a
particular ventricular radius
WT = [LV SP x LV radius] / LV wall
thickness
Study online at https://quizlet.com/_95671u
1. primary hypertension essential or idiopathic HTN; the
primary disease in question
*accounts for 95% of all cases of
HTN
*estimated that ¼ of the US popu-
lation has primary HTN
2. secondary hypertension HTN that is secondary to a prima-
ry disease
3. secondary hypertension of renal origin · chronic renal disease
· renal artery stenosis (“ blood flow
to kidneys makes them think sys-
temic BP is low ’ activate RAAS)
4. secondary hypertension of endocrine · adrenocortical hyperfunction
origin · hyperthyroidism
· pregnancy-induced (temporary)
5. secondary hypertension of hemody- · hypervolemia
namic / cardiovascular origin · rigidity of aorta
· coarctation of aorta
6. secondary hypertension of neurologic · ‘ intracranial pressure
origin · sleep apnea
7. major risk factors for hypertension · family hx
· age (‘ with age)
· gender (males younger than 55
y/o, women older than 74 y/o)
· race (‘ in African Americans)
· high dietary Na intake
· mineral deficiencies (K, Ca, Mg)
· DM (chronic endothelial dam-
age)
· smoking (chronic endothelial
damage)
· obesity (chronic endothelial
, Exam 3
Study online at https://quizlet.com/_95671u
damage)
· heavy ETOH consumption
· stress
8. true or false: Hypertension is a normal false
sign of aging.
Rationale: HTN is not a normal
sign of aging, although increased
age is a risk factor. If HTN does oc-
cur in older age (from hardening of
arteries), most pt's exhibit isolated
systolic HTN.
9. Why is it thought that African Ameri- a difference in the body's sensitiv-
cans are at increased risk for hyperten- ity to Na
sion & CVD?
10. 3 genetically linked physiological alter- 1. defects in renal Na homeostasis
ations that may lead to the develop- 2. functional vasoconstriction (‘
ment of primary hypertension sensitivity to circulating vasocon-
strictors)
3. defects in vascular smooth
muscle growth
11. How would a defect in renal Na home- inadequate Na excretion ’ Na /
ostasis lead to primary hypertension? H2O retention ’ ‘ plasma / ECF vol-
ume ’ ‘ CO ’ HTN
*exacerbated by ‘ Na intake
*‘ plasma / ECF volume also caus-
es ‘ release of natriuretic hormone
’ ‘ sensitivity to circulating vasocon-
strictors
12. natriuretic hormone hormone secreted by the atria of
the heart that decreases Na reten-
tion by the kidney
*opposes the effect of aldosterone
, Exam 3
Study online at https://quizlet.com/_95671u
13. How would functional vasoconstric- ‘ sensitivity to circulating vasocon-
tion lead to primary hypertension? strictors ’ ‘ TPR ’ HTN
14. How would a defect in vascular smooth ‘ vascular wall thickness ’ ‘ TPR ’
muscle growth lead to primary hyper- HTN
tension?
*sensitivity to circulating vasocon-
strictors also increases (potentiat-
ed by ‘ vascular wall thickness and
vice-versa)
15. What 2 ethnic/racial groups seem to · African-Americans
be similar in their increased risk for ·?
primary hypertension?
16. white coat hypertension phenomenon observed in the clin-
ical setting where pt's experience
a level of anxiety that causes their
BP to become elevated
*a "false positive" high BP reading
*opposite of masked HTN
17. masked hypertension phenomenon where a pt with
chronic HTN exhibits a lower BP
in the clinical setting
*a "false negative" healthy BP
reading
*opposite of white coat HTN
*thought to possibly be due to the
calm of a clinic office vs. the stress
of everyday life outside the clinical
setting
18. How do we screen someone for white 24-hr ambulatory BP monitoring
coat and masked hypertension?
used to calculate:
· avg 24-hr BP
, Exam 3
Study online at https://quizlet.com/_95671u
· avg waking BP
· avg nighttime BP
19. left ventricular hypertrophy (LVH) a cardiac condition in which the
left ventricle becomes enlarged
*most commonly due to HTN
(sometimes called "hypertensive
hypertrophy")
*a fairly early adaptation to chron-
ic HTN
*measured using sonography
("echo")
20. How can hypertension cause LVH? a chronically elevated afterload
requires stronger myocardium in
order to ‘ force of ventricular con-
traction
21. afterload the force of resistance against
which the heart pumps
22. preload degree of stretch of the cardiac
muscle fibers at the end of dias-
tole
*R/T volume of filling
23. wall tension the force needed to generate a
particular ventricular pressure at a
particular ventricular radius
WT = [LV SP x LV radius] / LV wall
thickness
