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40 Cards in this Set
- Front
- Back
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What does CAD stand for & it's usual cause?
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Coronary artery disease ... atherosclerosis
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What is CHD?
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Coronary heart disease ... process in arteries + diagnosis of angina, MI or HF
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What is a MI?
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Mycardial infarction ... Heart Attack ... interruption in blood supply to part of heart causing heart cells to die
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HTN causes damage what systems?
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Targeted Organ Damage ... heart, renal, retinal, brain - thrombotic stroke or hemorrhagic stroke; PVD
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Normal BP
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< 120/80
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BP considered pre-hypertensive
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120/80 - 139/89
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BP considered stage 1 HTN
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140/90 - 159/99
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BP considered state 2 HTN
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>160/100
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What is secondary HTN
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HTN related to something specific - 10% of cases
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What is primary HTN
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or idiopathic ... HTN w/ no cause - >90% of cases
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How is HTN diagnosed
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2 or more BP readings at 2 or more visits ... either systolic or diastolic elevated
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How is HTN treated?
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1st w/ lifestyle modification then add meds as needed
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What are classes of meds used to treat HTN?
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diuretics, beta-blockers, ACE inhibitors
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Reason on 1/3 of individuals diagnosed with HTN are controlled?
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1. poor access to healthcare + meds; 2. poor compliance; 3. not prescribed properly
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Risk factors for HTN
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1. smoking; 2. hypercholesteralemia; 3. obesity; 4. race (AA increased risk over W); 5. NaCl intake (>2.3g/day); 6. ETOH; 7. age
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Untreated HTN leads to ...
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1. arteries/ arterioles thicken to withstand stress .... narrowed lumen, vasoconstriction; leads to ... 2. hypertrophy & hyperplasia of smooth muscle
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Cardiovascular complications of HTN
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HTN is major risk factor for CVD, CAD, PAD .... 1. left ventricular hypertrophy & heart failure; 2. Stroke or TIA (trans ischemic attack); 3. angina & MI
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What's caused by malignant HTN
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severe cerebral pressure - marked HTN w/ retinal hemorrhage, exudates, papilledema ... underlying renal artery stenosis common = may lead to acute renal failure
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What lifestyle modifications support treating HTN
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1. DASH diet; 2. Low salt; 3. lose weight; 4. stop smoking; 5. lower lipid levels; 6. aerobic exercise - 150min/wk; 7. moderate ETOH intake; 8. K+ supplement
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What constitutes a HTN Urgency?
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diastolic > 120 - no symptoms ... no need for rapid drop but need to start meds
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What constitutes a HTN Emergency?
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BP >/+ 180/120 with damage to 2 organs ... acute/ life threatening
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What are the 2 forms of HTN Emergencies?
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1. malignant HTN - severe cerebral pressure & 2. hypertensive encephalopathy - neurological dysfunction caused by malignant HTN
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What can lead to malignant HTN
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usually chronic uncontrolled HTN = m/b didn't take meds for extended time or m/b not diagnosed before.
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What is hypertenisve encephalopathy?
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cerebral edema related to breakthrough hyperperfusion (increased membrane permeability) from severe or sudden rise in BP
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What can cause hypertensive encephalopathy?
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acute event .. malignant HTN, pre eclampsia or acute glomerular nephritis
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Goals for treating a HTN Emergency
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1. lower BP initially no more then 25% in 1st hour ... too sudden a drop leads to insufficient perfusion; 2. then continue to drop BP over 2-6 hrs for diastolic 100-105
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What is Atherosclerosis
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a type of artherosclerosis in large veins ... build up of plague that narrows the coronary artery lumen enough to impede blood flow ... also increases rigidity
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Atherosclerosis most commonly causes ...
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MI
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Why is arteriosclerosis exacerbated by HTN?
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the increased pressure over time changes the cell structure ... decreasing compliance
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What is arteriosclerosis?
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thickening & hardening/ stiffening of artery walls
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What is C Reactive Protein and its association w/ cardiovascular disease?
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protein found in the blood, the levels of which rise in response to inflammation (general marker for inflammation) ... important relationship with atherosclerosis ... increased CRP = increased CVD risk
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What's the optimal level for HDL?
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40 - 60
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What's the optimal level for LDL? What's borderline & what's high?
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<100; borderline is 130-159; high is >160
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What's the optimal level of total cholesterol panel? What's really high?
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optimal <200; really high >240
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What is CAD?
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heart disease due to impaired coronary blood flow
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How does decreased coronary blood flow affect the heart?
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decreases pumping ability of the heart by depriving heart of O2 + nutrients = diminishes myocardial blood supply until deprivation impairs myocardial metabolism
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Non-modifiable CAD risk factors
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1. age, 2. gender .. male + post menopausal women, 3. family history
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Modifiable CAD risk factors
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1. tobacco; 2. HTM; 3. hyperlipidemia; 4. diabetes; 5. physical inactivity; 6. abdominal obesity; 7. ETOH
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What BMI indicates Obesity?
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BMI of 30 or greater
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ABCDE for prevention of heart disease?
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A - antiplatelet/ anticoagulant drug therapy
B - Blood pressure drug therapy C - Cholesterol lowering drug therapy D - Diet/ weight loss E - Exercise |
