HYPERTENSION EXAM 2024
QUESTIONS WITH COMPLETE
SOLUTIONS
Factors Influencing BP - ANSWERSBlood pressure (BP), the force exerted by the blood
against the walls of the blood vessel, is primarily a function of cardiac output (CO) and
systemic vascular resistance.
CO is the total blood flow through the systemic or pulmonary circulation per minute. It is
described as the stroke volume (SV)(amount of blood pumped out of the left ventricle
per beat [approximately 70 pum]) multiplied by the heart rate (HR).
Systemic vascular resistance is the force opposing the movement of blood within the
blood vessels. The radius of the small arteries and arterioles is the principal factor
determining SVR. As arteries narrow, resistance to blood flow increases. As arteries
dilate, resistance to blood flow decreases. A small change in the radius of the arterioles
creates a major change in the SVR. If SVR is increased and CO remains constant or
increases, arterial BP will increase.
BP must be adequate to maintain tissue perfusion during activity and rest. The
maintenance of normal BP and tissue perfusion requires the integration of both
systemic factors and local peripheral vascular effects.
BP = CO x systemic vascular resistance
The mechanisms that regulate BP can affect either CO or SVR, or both.
Regulation of BP is a complex process involving both short-term (seconds to hours) and
long-term (days to weeks) mechanisms.
Short-term mechanisms, including the sympathetic nervous system (SNS) and vascular
endothelium, are active within a few seconds.
Long-term mechanisms include renal and hormonal processes that regulate arteriolar
resistance and blood volume. In a healthy person, these regulatory mechanisms
function in response to the demands of the body. (Each mechanism is more fully
described in the following slides.)
Endothelium Dysfunction
Endothelial dysfunction is recognized as a marker for CVD including primary hypert
Increased Hypertension = Increased Risk for.... - ANSWERSMI
Heart Failure
Stroke
Renal Disease
All of these risks are related to increase work from sustained high blood pressure.
, Primary Hypertension (Essential Hypertension) - ANSWERSNo Identifiable Cause*
It cause persistent increased Systemic Vascular Resistence because....
Increase BP = Increased Cardiac Output + Increased Systemic Vascular Resistance
Risk Factors for Primary Hypertension - ANSWERSAge
SBP rises progressively with increasing age although DBP may decrease with age.
After age 50, SBP >140 mm Hg is a more important cardiovascular risk factor than
DBP.
Age greater than 60. JNC-8 states if patient is >60 yo hypertension is 150/90
Alcohol
Excessive alcohol intake is strongly associated with hypertension.
Moderate intake of alcohol has cardioprotective properties; males with hypertension
should limit their daily intake of alcohol to 2 drinks per day, and 1 drink per day for
females with hypertension.
Tobacco use
Smoking tobacco greatly ↑ risk of cardiovascular disease.
People with hypertension who smoke tobacco are at even greater risk for
cardiovascular disease.
Diabetes mellitus
Hypertension is more common in diabetics.
When hypertension and diabetes coexist, complications (e.g., target organ disease) are
more severe.
High insulin levels stimulate SNS activity and impair nitric oxide-mediated vasodilation
Elevated serum lipids
↑ levels of cholesterol and triglycerides are primary risk factors in atherosclerosis.
Hyperlipidemia is more common in people with hypertension.
Excess dietary sodium
High sodium intake can contribute to hypertension in salt sensitive patients.
Decrease the effectiveness of certain antihypertensive drugs
Gender
Hypertension is more prevalent in men in young adulthood and early middle age.
After age 64, hypertension is more prevalent in women.
Postmenopausal
Family history
History of a close blood relative (e.g., parents, sibling) with hypertension is associated
with an ↑ risk for developing hypertension.
Children and siblings of persons with hypertension should be screened and strongly
advised to adopt healthy lifestyles to reduce their risk of hypertension
Obesity
Weight gain is associated with increased frequency of hypertension.
The risk is greatest with central abdominal o
While performing blood pressure screening at a health fair, the nurse counsels which
person as having the greatest risk for developing hypertension?
QUESTIONS WITH COMPLETE
SOLUTIONS
Factors Influencing BP - ANSWERSBlood pressure (BP), the force exerted by the blood
against the walls of the blood vessel, is primarily a function of cardiac output (CO) and
systemic vascular resistance.
CO is the total blood flow through the systemic or pulmonary circulation per minute. It is
described as the stroke volume (SV)(amount of blood pumped out of the left ventricle
per beat [approximately 70 pum]) multiplied by the heart rate (HR).
Systemic vascular resistance is the force opposing the movement of blood within the
blood vessels. The radius of the small arteries and arterioles is the principal factor
determining SVR. As arteries narrow, resistance to blood flow increases. As arteries
dilate, resistance to blood flow decreases. A small change in the radius of the arterioles
creates a major change in the SVR. If SVR is increased and CO remains constant or
increases, arterial BP will increase.
BP must be adequate to maintain tissue perfusion during activity and rest. The
maintenance of normal BP and tissue perfusion requires the integration of both
systemic factors and local peripheral vascular effects.
BP = CO x systemic vascular resistance
The mechanisms that regulate BP can affect either CO or SVR, or both.
Regulation of BP is a complex process involving both short-term (seconds to hours) and
long-term (days to weeks) mechanisms.
Short-term mechanisms, including the sympathetic nervous system (SNS) and vascular
endothelium, are active within a few seconds.
Long-term mechanisms include renal and hormonal processes that regulate arteriolar
resistance and blood volume. In a healthy person, these regulatory mechanisms
function in response to the demands of the body. (Each mechanism is more fully
described in the following slides.)
Endothelium Dysfunction
Endothelial dysfunction is recognized as a marker for CVD including primary hypert
Increased Hypertension = Increased Risk for.... - ANSWERSMI
Heart Failure
Stroke
Renal Disease
All of these risks are related to increase work from sustained high blood pressure.
, Primary Hypertension (Essential Hypertension) - ANSWERSNo Identifiable Cause*
It cause persistent increased Systemic Vascular Resistence because....
Increase BP = Increased Cardiac Output + Increased Systemic Vascular Resistance
Risk Factors for Primary Hypertension - ANSWERSAge
SBP rises progressively with increasing age although DBP may decrease with age.
After age 50, SBP >140 mm Hg is a more important cardiovascular risk factor than
DBP.
Age greater than 60. JNC-8 states if patient is >60 yo hypertension is 150/90
Alcohol
Excessive alcohol intake is strongly associated with hypertension.
Moderate intake of alcohol has cardioprotective properties; males with hypertension
should limit their daily intake of alcohol to 2 drinks per day, and 1 drink per day for
females with hypertension.
Tobacco use
Smoking tobacco greatly ↑ risk of cardiovascular disease.
People with hypertension who smoke tobacco are at even greater risk for
cardiovascular disease.
Diabetes mellitus
Hypertension is more common in diabetics.
When hypertension and diabetes coexist, complications (e.g., target organ disease) are
more severe.
High insulin levels stimulate SNS activity and impair nitric oxide-mediated vasodilation
Elevated serum lipids
↑ levels of cholesterol and triglycerides are primary risk factors in atherosclerosis.
Hyperlipidemia is more common in people with hypertension.
Excess dietary sodium
High sodium intake can contribute to hypertension in salt sensitive patients.
Decrease the effectiveness of certain antihypertensive drugs
Gender
Hypertension is more prevalent in men in young adulthood and early middle age.
After age 64, hypertension is more prevalent in women.
Postmenopausal
Family history
History of a close blood relative (e.g., parents, sibling) with hypertension is associated
with an ↑ risk for developing hypertension.
Children and siblings of persons with hypertension should be screened and strongly
advised to adopt healthy lifestyles to reduce their risk of hypertension
Obesity
Weight gain is associated with increased frequency of hypertension.
The risk is greatest with central abdominal o
While performing blood pressure screening at a health fair, the nurse counsels which
person as having the greatest risk for developing hypertension?
