What is hypertension (HTN)?
A consistent elevation in blood pressure above 130/80 mmHg (HTN Canada); must be confirmed with repeated readings.
What are the two main types of hypertension?
Primary (essential): no identifiable cause; Secondary: due to a specific cause (e.g., kidney disease, coarctation of the aorta).
What is atherosclerosis?
A form of arteriosclerosis characterized by plaque buildup in arterial walls leading to narrowed vessels and decreased perfusion.
Which concept is most related to hypertension and atherosclerosis?
Perfusion.
What mechanisms influence blood pressure?
Cardiac output (CO = stroke volume × heart rate) and peripheral vascular resistance (PVR).
What factors increase BP?
Increased sodium and water retention, increased CO, increased PVR, vessel stiffness with aging.
What role do arterial baroreceptors play in BP regulation?
Located in carotid sinus, aorta, and LV wall; sense pressure and trigger vasoconstriction or vasodilation to maintain BP.
How does kidney function affect BP?
Decreased BP triggers renin release → angiotensin II (vasoconstriction) → aldosterone (sodium/water retention) → increased BP.
How does plaque form in atherosclerosis?
Endothelial injury → fatty streak → fibrous plaque → complicated lesion (rupture → clot formation).
What are modifiable risk factors for hypertension?
Smoking, obesity, high sodium intake, alcohol use, sedentary lifestyle, stress, poor diet.
What are non-modifiable risk factors for hypertension?
Age, family history, ethnicity (Black, Indigenous).
What are modifiable risk factors for atherosclerosis?
High LDL, low HDL, hypertension, smoking, diabetes, obesity, stress, inactivity.
Why is hypertension called ‘the silent killer’?
It is often asymptomatic until target organ damage occurs.
What target organs are affected by hypertension?
Heart (LV hypertrophy, MI), brain (stroke), kidneys (nephrosclerosis), eyes (retinopathy), and peripheral arteries (PAD).
What are clinical manifestations of atherosclerosis?
Bruit, diminished pulses, chest pain (angina), fatigue, poor wound healing, and cold extremities.
Which lab tests are used to assess hypertension and atherosclerosis?
Urinalysis, electrolytes (Na, K), glucose, cholesterol, triglycerides, ECG, chest X-ray.
What are normal lipid level values?
Triglycerides: 0.40–1.70 mmol/L; HDL: 1.00–1.60 mmol/L; LDL: 1.60–3.50 mmol/L.
Using the Clinical Judgment Model, what are two key nursing hypotheses for hypertension?
- Need for health teaching related to hypertension management. 2. Potential for decreased adherence due to side effects.
In the CJM, what cues indicate atherosclerosis risk?
History of HTN, diabetes, smoking, stress, and elevated lipids.
What is the primary goal of hypertension therapy?
Reduce peripheral vascular resistance and circulating blood volume.
What are first-line drugs for hypertension?
Thiazide diuretics, ACE inhibitors, ARBs, and calcium channel blockers (CCBs).
Why are diuretics given for hypertension?
They decrease blood volume by promoting sodium and water excretion, lowering BP.
What common side effect occurs with ACE inhibitors?
Dry cough due to bradykinin buildup.
What is a key teaching point for patients on antihypertensive therapy?
Treatment is lifelong; do not stop medication abruptly; report side effects and monitor BP at home.
