Hypertension

By: Katie Kaminski

Background Information

Chambers of the Heart:
  • Right atrium
  • Right ventricle
  • Left atrium
  • Left ventricle

Valves of the Heart:

  • The tricuspid valve
  • The pulmonic or pulmonary valve
  • The mitral valve
  • The aortic valve

Major Blood Vessels:

  • Aorta
  • Left Pulmonary Arteries
  • Right Pulmonary Arteries
  • Pulmonary Trunk
  • Left Pulmonary Veins
  • Right Pulmonary Veins
  • Superior vena cava
  • Inferior vena cava


Blood Flow:

  • The right and left sides of the heart work together. The pattern described below is repeated over and over, causing blood to flow continuously to the heart, lungs, and body.


Conduction system of the heart:

  • Normally, the electrical impulse travels down both the right and left branches at the same speed. Thus, both ventricles contract at the same time. Occasionally there's a block in one of the branches, so impulses must travel to the affected side by a detour that slows them down. That means one ventricle contracts a fraction of a second slower than the other.



Pulse of Heart:

  • Your pulse is the rate at which your heart beats. Your pulse is usually called your heart rate, which is the number of times your heart beats each minute but the rhythm and strength of the heartbeat can also be noted, as well as whether the blood vessel feels hard or soft. Changes in your heart rate or rhythm, a weak pulse, or a hard blood vessel may be caused by heart disease or another problem.



5 Factors that influence blood pressure:

  • Tabacco Use
  • Age
  • Medications
  • Pregnancy
  • Genetics


Blood Pressure:

  • The pressure of the blood in the circulatory system, often measured for diagnosis since it is closely related to the force and rate of the heartbeat and the diameter and elasticity of the arterial walls.



Cardiac Cycle:

  • A complete beat of the heart, including systole and diastole and the intervals between, beginning with any event in the heart's action to the moment when that same event is repeated.



Stroke Volume:


  • The stroke volume is not all the blood contained in the left ventricle; normally, only about two-thirds of the blood in the ventricle is expelled with each beat. Together with the heart rate, the stroke volume determines the output of blood by the heart per minute (cardiac output).


3 Blood Tests:


  • Hematocrit Test: The hematocrit blood test determines the proportion of red blood cells (RBC's) in the blood. The hematocrit is recorded as the percentage of volume of red blood cells in a blood sample. A blood sample is composed mainly of red blood cells and white blood cells suspended in blood serum. The hematocrit test indicates the percentage of blood by volume that is composed of red blood cells.
  • WBC count: A WBC count is a blood test to measure the number of white blood cells (WBCs). White blood cells help fight infections. They are also called leukocytes.
  • Platelet Count: A platelet count is a test to measure how many platelets you have in your blood. Platelets help the blood clot. They are smaller than red or white blood cells.












Case Study

Hypertension



Essential Hypertension:


  • In as many as 95% of reported high blood pressure cases in the U.S., the underlying cause cannot be determined. This type of high blood pressure is called essential hypertension.Though essential hypertension remains somewhat mysterious, it has been linked to certain risk factors. High blood pressure tends to run in families and is more likely to affect men than women. Age and race also play a role. In the United States, blacks are twice as likely as whites to have high blood pressure, although the gap begins to narrow around age 44. After age 65, black women have the highest incidence of high blood pressure.






Secondary Hypertension:


  • When a direct cause for high blood pressure can be identified, the condition is described as secondary hypertension. Among the known causes of secondary hypertension, kidney disease ranks highest. Hypertension can also be triggered by tumors or other abnormalities that cause the adrenal glands (small glands that sit atop the kidneys) to secrete excess amounts of the hormones that elevate blood pressure. Birth control pills -- specifically those containing estrogen -- and pregnancy can boost blood pressure, as can medications that constrict blood vessels.











Causes:


  • Smoking
  • Being overweight or obese
  • Lack of physical activity
  • Too much salt in the diet
  • Too much alcohol consumption (more than 1 to 2 drinks per day)
  • Stress
  • Older age
  • Genetics
  • Family history of high blood pressure
  • Chronic kidney disease
  • Adrenal and thyroid disorders

EKG Results:





  • The ECG is often used as an inexpensive, initial screening tool to assess target organ damage in a hypertensive patient. It can be used to assess the presence of left atrial enlargement, LVH, MI, myocardial ischemia, ventricular premature beats, and AF. Left atrial enlargement -- one of the earliest ECG findings of hypertensive heart disease -- is said to be present if the terminal portion of the P wave has a duration of 0.04 seconds and a depth of 1 mm or more or their product is ≥ -0.04 mm x sec. ECG LVH with "strain pattern" is the most lethal classic Framingham cardiovascular risk factor.

Pulse Results:


  • High blood pressure, refers to increased pressure in the arteries of the body. Pulse rate, on the other hand, is a measurement of the number of times the heart beats in 1 min. as the resistance in the arteries increases due to the high blood pressure, the heart responds by pushing less blood, which brings down the heart rate.

Blood Pressure Results:



  • Blood pressure readings fall into four general categories, ranging from normal to stage 2 hypertension (high blood pressure). The level of your blood pressure determines what kind of treatment you may need. To get an accurate blood pressure measurement, your doctor should evaluate your readings based on the average of two or more blood pressure readings on each of two office visits.


Top number (systolic) in mm Hg Bottom number (diastolic) in mm HgYour category*What to do**

Below 120andBelow 80Normal blood pressureMaintain or adopt a healthy lifestyle.

120-139or80-89PrehypertensionMaintain or adopt a healthy lifestyle.

140-159or90-99Stage 1 hypertensionMaintain or adopt a healthy lifestyle. If blood pressure goal isn't reached in about six months, talk to your doctor about taking one or more medications.

160 or moreor100 or moreStage 2 hypertensionMaintain or adopt a healthy lifestyle. Talk to your doctor about taking more than one medication.