My Blood Pressure Is Through The Roof

Hypertension

can be diagnosed by

Accurate BP measurement

Medical History

Physical Examination

Lab tests

Electrocardiography

is determined by

average of 3 BP readings taken 2 minutes for two weeks

includes

Assessment of Obesity

involves

BMI

Waist-hip ratio

such as

Urinalysis

Blood Chemistry

Fasting Blood Glucose

Serum total Cholesterol

HDL, LDL & non-HDL Cholesterol

Triglycerides

Urinary Albumin excretion

for

diabetic patients

Anatomy of Arterial System

Histology of Arteries

includes

complications

in

head and brain

such as

stroke

heart

such as

peripheral artery disease

such as

ulcers

gangrene

claudication

coronary artery disease

Hypertensive Retinopathy

heart failure

kidney failure

Hemodynamics

Blood flow

is determined by

Vascular resistance

Pressure gradient

image

is defined as

Quantity of blood

Types

Velocity

Cross section area

image

image

Laminar

Turbulent

Re < 2000

Re> 3000

image

image

Resistance

is determined by

Blood viscosity

Total blood vessels length

BV diameter

image

Pulse pressure

Blood pressure

Defined as

Depends on

Force that produced against BV walls

CO

TPR

BV

is

Depends on

SBP - DBP

SV / Compliance

image

Divided to

Head

Thorax

Neck

Abdomen and pelvis

Lower limbs

Upper limbs

Contains

Common carotids

Which branches into

External carotid

Internal carotid

That continues

To the brain

Vertebral arteries

Which are a branch of

Subclavian arteries

Vertebral arteries

Combine to form

Basilar arteries

That give off

Posterior cereberal arteries

Internal carotid

That give off

Anterior cereberal artery

Middle cereberal artery

Supplied by

Anterior intercoastal arteries

Posterior intercoastal arteries

A branch of

Internal thoracic arteries

A branch of

Subclavian arteries

A branch of

Thoracic aorta

Gives off

Pericardiophrenic arteries

That supply

The pericardium and diaphragm

Abdominal aorta has

3 unpaired branches

Which are

Celiac trunk

Superior mesenteric

Inferior mesenteric

Supply

The GIT

can be defined as

mean blood pressure of 140/90 mm Hg or higher and/or current use of antihypertensive medication.

Abdominal aorta divides into

R&L common illiacs

Give off

Internal illiac

External illiac

classified into

Primary Hypertension

Becomes

Femoral artery

Secondary Hypertension

Becomes

Popliteal artery

Becomes

Subclavian artery

Becomes

Axillary artery

Becomes

Brachial artery

Divides into

Ulnar artery

is defined as

is caused by

environmental factors

genetic factors

interactions of both

is defined as

is caused by

Muscular arteries

Arterioles

Elastic arteries

increase production of renin

Has

Thick tunica intima consisting of endothelial cells supported by connective tissue

Adrenal disease

Thick tunica media with prominent elastice fibers and some smooth muscle and collagen

Hyperparathyroidism

Thyroid problems

Tunica externa made of collagen and vasa vasorum

Coarctation of the aorta

Obstructive sleep apnea

Such as

Aorta and its branches

Pulmonary trunk and arteries

Medications

Has

Prominent smooth muscles in tunica media with few elastic fibers and collagen

Tunica externa as thick as tunica media

Thinner tunica intima with prominent IEL

Such as

Femoral - brachial - radial arteries

Worldwide

Has

1-3 layers of smooth muscles in tunica media

Thin and underdeveloped tunica externa

Thin tunica intima consiting of endothelium only

can lead to

leads to

Pheochromocytoma

Conn’s syndrome

Cushing’s syndrome

due to

collapsed passages in the upper airways

can be treated using

26% of the world's population (972 million people) in 2019

in Qatar

Nearly 75% of people with
hypertension live in developing countries

Antihypertensive Drugs

divided into

Beta-Blockers

ACE Inhibitors

Alpha-Blockers

Diuretics

Calcium Channel Blockers

include

Loop-diuretics

K+ Sparing diuretics

Thiazide

33% of adult population

for example

Hydrochlorothiazide

for example

Furosemide

for example

Amiloride

end with

more in females than males

end with

"pril"

for example

ARBs

end with

" sartan"

ends with

"ide"

Captopril

for example

"lol"

for example

Metoprolol

divided into

selective

Non-selective

contraindicated in

ends with

"osin"

for example

Prazosin

Checking pulse

Checking for bruits in abdomen and neck

Examining legs for any edemas

Checking the thyroid and for distended neck veins

checking the retina

divided into

Dihydropyridines

Non-Dihydropyridines

ends with

"dipine"

for example

Amlodipine

to rule out

radio-radial delay

radio-femoral delay

which are

the sound of blood flowing through narrow arteries

using

fundoscopy

for example

Verapamil

in emergency cases

CCBs

Adrenergic receptors blockers

Vasodilator

such as

such as

such as

Nicardipine

Esmolol

Hydralazine

high blood pressure caused by another condition or disease

high blood pressure that is multi-factorial and doesn’t have one distinct cause, known also as idiopathic or essential hypertension

Blood pressure Regulation

is by

Baroreceptors

classified based on location

Arterial baroreceptors

divided into two

Aortic Arch

together

will work on multiple Centers located in the brain stem to regulate the change in blood pressure

Carotid sinus

Losartan

asthma patients

Kidney disease

Radial artery

Kidney regulation

Cardiopulmonary baroreceptors

Those centers are

Vasomotor center (SNS)

Cardiac center

further divided into

Accelerator center (SNS)

Has effect on

Heart rate

Contractility

Deaccelerator center (PSNS)

Has effect on

Heart rate

Through

Release of Renin

image

Atherosclerosis

defined as

A vessel wall thickening

caused by the accumulation of

intimal smooth muscle cell

proliferation of intimal- smooth muscle cell

fatty streak

starts with

Endothelial Dysfunction

can cause

mast cells invasion

Foam cells formation

fibrose cap formation

monocyte ---->macrophage

ends with

Rupture of the thrombus

Lipoprotein Entry and Modification