Hypertension
⮚ Definition:
o The amount of RESISTANCE of blood pumping through the body/ arteries
▪ Narrowing of the arteries increasing the blood pressure
▪ Arteries are constricting and the blood is just jetting through
● “Think of how the water hose work”
o Insidious ⮚ ASYMPTOMATIC
⮚ BP = CO x PVR (peripheral vascular resistance)
o CO = HR x SV (stroke volume – pumped out from left ventricle)
o Narrow or thickened blood vessel causes high
⮚ According to the JNC7 (Joint National Committee): systolic/diastolic
o Normal:
▪ <
o Pre HTN:
▪ 120 – – 89
o Hypertension (2 stages)
▪ Stage 1 hypertension:
● 140 – 159/ 90 – 99
▪ Stage 2 hypertension:
● > 160 / > 100
⮚ ORGANS that are affected by hypertension
o Hypertension is known as the “SILENT KILLER”
▪ People can have hypertension and not even know it
● It just doesn’t present with symptoms ⮚ ASYMPTOMATIC
▪ When symptoms do present, it means it already has affected that part (organ) of the body
● When specific signs and symptoms appear, they usually indicate vascular damage,
with specific manifestations related to the organs served by the involved vessels
● Blurred vision (eyes)
o “Can’t eat your CAKE” ⮚ pneumonic
▪ CARDIOVASCULAR
● Coronary artery disease (CAD) with angina and Myocardial Infarction are
common consequences of hypertension
● Left VENTRICULAR HYPERTROPHY occurs in response to the INCREASED
workload placed on the ventricle as it contracts against higher systemic pressure
● When heart damage is extensive, HEART FAILURE follows
● Cause CHF ⮚ due to the overworking of the heart
o Overworking of the heart muscle ⮚ LEFT ventricle ENLARGES
o From the left ventricle blood goes back to the LUNGS – Heart failure
o Ventricle enlarges and it doesn’t pump well due to the INCREASED pressure
▪ BRAIN (cerebrovascular)
● Stroke ⮚ TIA (transient ischemic attack)
o Manifested by:
▪ Alteration in VISION or SPEECH
▪ Dizziness
▪ Weakness
▪ A sudden fall
, ▪ Transient or permanent PARALYSIS on one side (HEMIPLEGIA)
● Due to that increased pressure going through the body
● Causes the ARTERIES to WEAKEN and/or RUPTURE
o When arteries rupture, a stroke can happen
▪ KIDNEYS
● Renal failure
● All that blood going to the kidneys at such a HARD and FAST RATE weakens the
arteries in the kidneys which DECREASES perfusion
● Indicated by INCREASED blood urea nitrogen (BUN) and serum creatinine
levels
o May manifest as NOCTURIA (excessive urination at night)
▪ EYES
● Retina changes
● All that hard blood flow going to the eyes and it wears out the vessels to the retina
● Causes:
o Blurry vision
o Patients can’t focus objects
● Retinal changes such as hemorrhages,
exudates (fluid accumulation),
arteriolar narrowing,
and cotton-wool spots (small infarctions) occur
● In severe hypertension:
o PAPILLEDEMA (swelling of the optic disc) may be seen
⮚ The typical outcomes of prolonged, uncontrolled hypertension are:
o MI ⮚ Myocardial Infarction (heart attack) ⮚ Heart failure
o Renal failure (renal dysfunction ⮚ retaining water, sodium, and chloride) =That’s the whole reason
why your given diuretics, because hypertension caused renal failure due to the constriction of the
arterioles. So now, you’re retaining all of that fluid such as sodium, water and chloride, and by
giving the diuretic it will help you excrete all that fluid
o Strokes and impaired vision
You see hypertension causes several different outcomes and by giving certain types of medications will relieve
those outcomes. If a patient has renal failure you would give a diuretic & it would act on the kidneys. If a
patient has an angina due to chronic constriction giving CCB would help this.
⮚ CAUSES of hypertension
o There are 2 types:
▪ Primary/ Essential HTN
▪ Secondary HTN
1. Primary/ Essential Hypertension ⮚ In addition to hypertension
a. Unknown cause (idiopathic)… look at “RISK FACTORS”
● Race (African American males)
● Increase intake of Na+ (sodium) and ETOH (alcohol)
● Smoking/ Stress
o Cigarette smoking does NOT cause hypertension
o However, if a person with hypertension smokes, his or her risk of dying of
heart disease or related disorders increases significantly
● K+ (potassium) and Vitamin D (with kidneys retain enzymes) intake is LOW
o Potassium helps balance sodium
o Low potassium means increased sodium so INCREASE BP (HTN)
⮚ Definition:
o The amount of RESISTANCE of blood pumping through the body/ arteries
▪ Narrowing of the arteries increasing the blood pressure
▪ Arteries are constricting and the blood is just jetting through
● “Think of how the water hose work”
o Insidious ⮚ ASYMPTOMATIC
⮚ BP = CO x PVR (peripheral vascular resistance)
o CO = HR x SV (stroke volume – pumped out from left ventricle)
o Narrow or thickened blood vessel causes high
⮚ According to the JNC7 (Joint National Committee): systolic/diastolic
o Normal:
▪ <
o Pre HTN:
▪ 120 – – 89
o Hypertension (2 stages)
▪ Stage 1 hypertension:
● 140 – 159/ 90 – 99
▪ Stage 2 hypertension:
● > 160 / > 100
⮚ ORGANS that are affected by hypertension
o Hypertension is known as the “SILENT KILLER”
▪ People can have hypertension and not even know it
● It just doesn’t present with symptoms ⮚ ASYMPTOMATIC
▪ When symptoms do present, it means it already has affected that part (organ) of the body
● When specific signs and symptoms appear, they usually indicate vascular damage,
with specific manifestations related to the organs served by the involved vessels
● Blurred vision (eyes)
o “Can’t eat your CAKE” ⮚ pneumonic
▪ CARDIOVASCULAR
● Coronary artery disease (CAD) with angina and Myocardial Infarction are
common consequences of hypertension
● Left VENTRICULAR HYPERTROPHY occurs in response to the INCREASED
workload placed on the ventricle as it contracts against higher systemic pressure
● When heart damage is extensive, HEART FAILURE follows
● Cause CHF ⮚ due to the overworking of the heart
o Overworking of the heart muscle ⮚ LEFT ventricle ENLARGES
o From the left ventricle blood goes back to the LUNGS – Heart failure
o Ventricle enlarges and it doesn’t pump well due to the INCREASED pressure
▪ BRAIN (cerebrovascular)
● Stroke ⮚ TIA (transient ischemic attack)
o Manifested by:
▪ Alteration in VISION or SPEECH
▪ Dizziness
▪ Weakness
▪ A sudden fall
, ▪ Transient or permanent PARALYSIS on one side (HEMIPLEGIA)
● Due to that increased pressure going through the body
● Causes the ARTERIES to WEAKEN and/or RUPTURE
o When arteries rupture, a stroke can happen
▪ KIDNEYS
● Renal failure
● All that blood going to the kidneys at such a HARD and FAST RATE weakens the
arteries in the kidneys which DECREASES perfusion
● Indicated by INCREASED blood urea nitrogen (BUN) and serum creatinine
levels
o May manifest as NOCTURIA (excessive urination at night)
▪ EYES
● Retina changes
● All that hard blood flow going to the eyes and it wears out the vessels to the retina
● Causes:
o Blurry vision
o Patients can’t focus objects
● Retinal changes such as hemorrhages,
exudates (fluid accumulation),
arteriolar narrowing,
and cotton-wool spots (small infarctions) occur
● In severe hypertension:
o PAPILLEDEMA (swelling of the optic disc) may be seen
⮚ The typical outcomes of prolonged, uncontrolled hypertension are:
o MI ⮚ Myocardial Infarction (heart attack) ⮚ Heart failure
o Renal failure (renal dysfunction ⮚ retaining water, sodium, and chloride) =That’s the whole reason
why your given diuretics, because hypertension caused renal failure due to the constriction of the
arterioles. So now, you’re retaining all of that fluid such as sodium, water and chloride, and by
giving the diuretic it will help you excrete all that fluid
o Strokes and impaired vision
You see hypertension causes several different outcomes and by giving certain types of medications will relieve
those outcomes. If a patient has renal failure you would give a diuretic & it would act on the kidneys. If a
patient has an angina due to chronic constriction giving CCB would help this.
⮚ CAUSES of hypertension
o There are 2 types:
▪ Primary/ Essential HTN
▪ Secondary HTN
1. Primary/ Essential Hypertension ⮚ In addition to hypertension
a. Unknown cause (idiopathic)… look at “RISK FACTORS”
● Race (African American males)
● Increase intake of Na+ (sodium) and ETOH (alcohol)
● Smoking/ Stress
o Cigarette smoking does NOT cause hypertension
o However, if a person with hypertension smokes, his or her risk of dying of
heart disease or related disorders increases significantly
● K+ (potassium) and Vitamin D (with kidneys retain enzymes) intake is LOW
o Potassium helps balance sodium
o Low potassium means increased sodium so INCREASE BP (HTN)
