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
is defined as
Quantity of blood
Types
Velocity
Cross section area
Laminar
Turbulent
Re < 2000
Re> 3000
Resistance
is determined by
Blood viscosity
Total blood vessels length
BV diameter
Pulse pressure
Blood pressure
Defined as
Depends on
Force that produced against BV walls
CO
TPR
BV
is
Depends on
SBP - DBP
SV / Compliance
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
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