hypertension with jnc7 and mnt

hypertension with jnc7 and mnt - Hypertension: Medical...

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Hypertension: Medical Management and Nutritional Approaches
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Hypertension Persistently high arterial blood pressure Systolic blood pressure above 140 mm Hg and/or diastolic blood pressure above 90 mm Hg Normotensive = 120/80 mm Hg Prehypertensive = 120–139/80-89 mm Hg Stage 1 hypertension = 140–159/90- 99 mm Hg Stage 2 hypertension = >160/>100 mm Hg
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Prevalence and Incidence 29% of adult US population Related to body mass index High prevalence in African Americans 5% of pediatric population; prevalence increases with age Strong positive relationship between blood pressure and risk of CVD events
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Pathophysiology Blood pressure is a function of cardiac output multiplied by peripheral resistance Affected by diameter of blood vessel Atherosclerosis decreases diameter, increases blood pressure Drug therapy increases diameter, lowers blood pressure
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Circulatory Systems in the Body 1. Coronary—supplies blood to heart muscle (can form collateral circulation) 2. Cerebral—supplies blood to head 3. Splanchnic—supplies blood to abdomen (exercise removes blood and food attracts blood to this area) 4. Pulmonary—supplies blood to lungs (O 2 and CO 2 exchange)
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Measures of Heart Function 1. Beats or pulse 2. BP systolic and diastolic 3. ECG
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Determinants of Blood Pressure 1. Blood volume 2. Vascular resistance to pressure 3. Heart stroke volume
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Cardiac Output Amount of blood pumped by heart (vol/min) Stroke volume times heart rate
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Vascular Resistance Viscosity of blood Width of vessels—(constriction or dilation)—controlled by muscle tone in vessel walls
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Regulation of Blood Pressure 1. Sympathetic nervous system (SNS)—responds immediately; baroreceptors monitor BP Vasomotor center in brain SNS innervated tissues contract or dilate vascular bed 2. Renin-angiotensin system—retains Na and H 2 O to increase blood volume; constricts blood vessels; increases aldosterone 3. Kidneys—respond to renin-angiotensin system; aldosterone and antidiuretic hormone (ADH) are sent out as needed
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Homeostatic Control of Blood Pressure Short term —Sympathetic nervous system —Vasoconstriction —Vasodilation Long term —Fluid volume —Renin-angiotensin system
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Hypertension 1. 90% HTN is essential HTN (cause unknown; perhaps prenatal impacts?) 2. 10% HTN is secondary to other diseases 3. HTN is a risk factor for MI, CVA, renal failure
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Renin-Angiotensin Cascade Redrawn from Guyton AC: Textbook of medical physiology, ed 8, Philadelphia, 1991, WB Saunders.
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Causes of Hypertension Algorithm content developed by John Anderson, PhD, and Sanford C. Garner, PhD, 2000.
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Hypertension (Adapted from National High Blood Pressure Education Program Working Group report on primary prevention of hypertension. Arch Intern Med 153:186, 1993. Copyright 1993, American Medical Association. Reprinted with permission.)
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hypertension with jnc7 and mnt - Hypertension: Medical...

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