Actual Answers.
RAAS regulates long-term BP and extracellular volume
1. Angiotemsionogen released by the liver in response to low BP and changes in blood volume
2. Low fluid volume stimulates the kidney to release renin which causes the liver to convert
angiotensinogen to angiotensin I
3. Angiotensin I travels to the lung where it is converted by Angiotensin II by ACE (angiotensin-
converting enzyme)
4. Angiotensin II acts on the adrenal glands to cause the release of aldosterone, which then
causes fluid retention
5. Angiotensin II is a potent vasoconstrictor-- it also seems to cause inappropriate remodeling of
the heart after a heart attack
6. This ultimately causes the nephron to retain fluid and the BP goes up - Answer Renin
Angiotensin Aldosterone System
- receptors in the carotid sinus, aorta, and left ventricle
- sense BP and can alter the BP by altering heart rate
- can also impact vasodilation and vasoconstriction - Answer Arterial baroreceptors
- helps maintain consistent levels of tissue perfusion
- regulates based on mean arterial pressure
- alters the resistance (diameter) in arterioles
- helps keep consistent BP at the tissue levels despite changes that are occurring in other
mechanisms - Answer Vascular autoregulation
Systolic— less than 120 AND Diastolic— less than 80 - Answer Normal BP
Systolic— 120-129 AND
Diastolic— less than 80 - Answer Elevated BP
Systolic— 130-139 OR
Diastolic— 80-89 - Answer High BP Stage 1
, Systolic— higher than 180 AND/OR
Diastolic— higher than 120 - Answer Hypertensive crisis
- Occurs when there is NO KNOWN CAUSE of hypertension— usually because of an absence of
underlying disease process
- Occurs due to complicated interactions of genetics and the environment, and involving several
neurohormonal effects (SNS, RAAS, Natriuretic peptides) - Answer Primary/Essential
hypertension
- smoking
- excess sodium intake
- sedentary lifestyle
- hyperlipidemia
- stress
- family history and genetics
- obesity
- age >60
- African Americans
- high alcohol consumption - Answer Risk factors for primary hypertension
- hypertension with a KNOWN cause
- usually related to underlying disease or disorder: health conditions, certain medicines,
pregnancy, hormonal therapy, renal disease, tumors, drugs such as corticosteroids,
antihistamines, cocaine, and amphetamines
- treatment is to treat the underlying cause - Answer Secondary hypertension
NO! "silent killer"
- must look for signs of end-organ damage: chest pain (heart), headache (brain), visual changes
(eyes), weakness or pain in extremities (brain/stroke) - Answer Are there signs and symptoms
of hypertension?
- increased left ventricular work