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20 Cards in this Set

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What is the conceptual definition of hypertension?
The level of pressure at which the benefits (minus the risk an costs) of action (medical evaluation and treatment) exceed the rsiks fo inaction.
What is the operational definition of hypertension?
Hypertension is defined as a systolic pressure greater than 140 and a diastolic greater than 90 based on three sets of mearsurements over several weeks.
What are the three major end organ diseases and 2 vascular diseases to which hypertension is a major contributor?
1. Brain - stroke due to thrombosis or hemorrhage
2. Heart - heart disease due to L ventricular hypertrophy/subsequent CHF; coronary artery disease

3. Kidneys - chronic renal failure secondary to glomerular arteriolar nephrosclerosis.

Vascular
1. Abdominal aortic aneurysm
2. peripheral vascular disease - secondary to accelerated atherosclerosis
Name six potential adverse conseqences for a patient as a consequence of being diagnosed and/or treated for hypertension.
1. burden of being labeled "hypertensive"
2. interference with quality of life
3. lifestyle changes (diet, exercise)
4. life insurance increase
5. adverse effects to drug therapy
6. costs of treatment
What is the prevalence of hypertension in people ages 35-44 and over 65?
35-45 = 20%

over 65 = 60%
What is the exact cause of hypertension?
No one knows
What is secondary hypertension?
Hypertension that is secondary to some other identifiable problem - there fore it is sometimes fixable.
Four secondary sources of hypertension?
1. kidney diseases
2. endocrine tumors
3. coarctation of the aorta
4. drugs (alcohol, cocaine, oral contraceptives)
What is the formula for BP?
BP = CO x peripheral resistance
When you finally are able to diagnose a patient with primary hypertension what will that patient also have (3)?
1. Elevated peripheral vascular resistance
2. normal CO
3. artheroschlerosis
What is the hemodynamic hallmark of elevated BP?
Elevated vascular resistance
What does the perpetuation of hypertension depend on?
Development of vascular hypertrophy within smaller arterioles (primary determinant of peripheral vascular resistance).
VIP

What are four cardiovascular risk factors that, in combination with hypertension, increase the likelihood of the patient having a stroke or MI?
1. hyperlipidemia
2. cigarette use
3. diabetes mellitus
4. family history of early cardiovascular disease
What is the major symptom of high BP?
high BP is asymptomatic!! Got you!
For patients with long standing high BP may present with what five symptoms are due to target organ disease?
headache, dizziness, stroke, chest pain (coronary diseae), leg pain (insuff oxygen delivery)
Three rare symptoms of high BP causes by secondary causes of hypertension?
1. pheochromocytoma
2. glucocorticoid excess
3. renal disease flank pain and hematuria
On a patient with sustained high BP and lung target organ disease what is one sign?
rales
What happens to pulses in the extremities of hypertensive patients?
diminish
VIP

What are two test for cardiac risk factors?
cholesterol
glucose
Three tests done on a hypertensive patient to test for target organ disease?
1. EKG
2. proteinuria
3. increased serum creatinine due to reduced glomerular filtration rate.