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What is the definition of hypertension?
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Persistent systolic pressure above 140, diastolic above 90, OR current use of antihypertensive meds
What disease states have been linked to hypertension? (5)
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Cardiovascular disease, MI, heart failure, stroke and renal disease
What is pre-hypertension?
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A persistent SBP of 120-139 or DBP of 80-89
_______ is the force exerted by blood against the walls of the blood vessel.
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Blood pressure
_______ is the force opposing movement of blood within the blood vessels.
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Systemic Vascular Resistance (SVR)
What is the major determinant of systemic vascular resistance?
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The radius of small arteries and arterioles
What systems are involved in the short term regulation of blood pressure?
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SNS and vascular epithelium
At what age does hypertension become more common in women than men?
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55
Men with hypertension are more likely to suffer strokes or MI?
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MI
Women with hypertension are more likely to suffer strokes or MI?
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Strokes
Why do African Americans not respond as well to angiotensin inhibitors used to treat hypertension?
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They produce less renin
Who has a higher incidence of hypertension, African American women or men?
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Women (more than 75% over 75 have it)
What impact does the SNS have when a decrease in arterial pressure is detected?
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Increased HR, increased contractility, widespread vasoconstriction in peripheral arterioles, and stimulates the kidneys to release renin. All work to raise arterial pressure by increasing CO and SV.
The PNS decreases the heart rate via the _______ nerve.
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Vagus
Where are the receptors located that are activated by norepinephrine?
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The SA node, myocardium, and vascular smooth muscle
______ receptors are located in the peripheral vasculature and cause constriction when stimulated by norepinephrine.
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Alpha adrenergic receptors
How do beta 1 adrenergic receptors in the heart respond to norepinephrine?
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Increased heart rate (chronotropic), increased force of contraction (inotropic) and increased conduction speed
Beta 2 Adrenergic receptors are activated primarily by epinephrine released by the _______ and respond with vasodilation.
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Adrenal medulla
Which part of the brain is the control center for BP regulation?
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The vasomotor center in the medulla
Which SNS receptors, when stimulated, cause vasoconstriction?
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Alpha 1, Alpha 2, and Beta 1
_______ sense the rise and fall of blood pressure and suppresses or initiates SNS activity in response.
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Baroreceptors
_______ is a potent vasoconstrictor produced by the vascular endothelium.
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Endothelin (three subclasses, ET-1-ET-3)
_____ is the subclass of endothelin that is the most potent vasoconstrictor and also causes adhesion and aggregation of neutrophils and stimulates smooth muscle growth.
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ET-1
______ is produced by the vascular endothelium and helps maintain low arterial tone at rest, inhibits growth of the smooth muscle layer and inhibits platelet aggregation.
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Nitric oxide (an endothelium-derived relaxing factor/EDRF)
What events trigger the secretion of renin from the kidneys? (3)
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SNS stimulation, decreased bloodflow to the kidneys or low serum sodium
How does Angiotensin II work locally on the heart?
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It vasoconstricts the heart and causes tissue growth that results in remodeling of the vessel walls (this is bad)
How do the kidneys decrease blood pressure?
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The renal medulla secretes prostaglandins (PGE1 & PGE2) causing vasodilation
How does the heart decrease blood pressure?
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The cardiac cells secrete ANP and BNP which antagonizes ADH and Aldosterone causing the kidneys to eliminate sodium and water
What areas of the body vasoconstrict in response to the release of epinephrine? Why?
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The kidneys and skin, they only have alpha 1 adrenergic receptors
Which subtype of hypertension? Average SBP of 140 or more/ DBP less than 90 Common in older adults, caused by loss of elasticity in the large arteries from atherosclerosis
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Isolated hypertension


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