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Cardiovascular disorders


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Definition of Hypertension
BP >140/90
In elderly >160/90
Essential Hypertension
-no specific cause,r/t increased peripheral resistance
Contributing factors to HTN
obesity, smoking, stress(stimulates nervous system to vasoconstrict), arteriosclerosis and atherosclerosis, + family hx, ^age, african american, diet ^ in salt and saturated fats.
Regulation of BP
Sympathetic nervous system- Increases BP
Parasympathetic- Decreases BP
Adrenal glands- Renin-angiotension-aldosterone system
Secondary HTN
An underlying disease or abnormality EX: Renal Abnormalities, endocrine and metablic disorders, CNS disorders, Coarctation of the aorta, pheochromocytoma
Malignant HTN
Diastolic > 120 Ex: 200/122
-causes retinopothy, kidney damage, brain damage.
Hypertensive Crisis
BP suddenly goes up; systolic >240
-caused by stopping BP meds abruptly
-s/s CHF and CNS dysfunction; cerebral dysfunction, lethargic, N/V, convulsions
Treatment of Hypertensive Crisis
Nitroprusside (vasodialator) and diuretics.
HTN effects on body
Damage to eyes, heart, kidneys, brain and abnormalities can be found on physical exam and diagnostic tests.
HTN Mod. to severe Complications and Clinical Findings. (Prolonged ^ BP)
Headaches, dizziness and fatigue, palpitations, nosebleeds. Retinal hemorrhage, narrowing of arterials, L ventricular enlargement, freq. urination, ^BUN, ^creatine,(r/t kidney function), ^K+
Complications of untreated/uncontrolled HTN
Decreased life expectancy, heart attack, blindness, kidney failure, stroke
Medications for HTN
Angiotensin-converting Enzyme Inhibitors (ACE inhibitors), Calcium Antagonists, Beta-Adrenergic Blockers
increase excretion of NA and water.(if on lasix prob on K+).
Lasix, Thiazides, K+ sparing(Aldactone). IV push can cause hearing loss, PO does not. Monitor I/O
Beta-Adrenergic Blockers

decrease BP(inhibits sympathetic NS), also decrease pulse. Methyldopa, Propanolol, clonidine.
-acts on smooth muscles(decreases periphral resistance) Hydralazine.
Calcium Antagonists

ACE inhibitors
-increase CO & tissue perfusion= decreased preload and afterload resistance. Diltiazem hydrochloride, nifedipine
-ACE inhibitor; captopril

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