chapter 34_ hypertension课件

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1、Chapter33:HypertensionOverviewofBPPg.507Forceproducedbythevolumeofbloodwithinthewallsofarteries.Measuredpressurereflectstheabilityofarteriestostretchandfillwithblood,efficiencyofheartasapumpandthevolumeofcirculatingbloodOverviewofBPAffectedbyage,bodysize,diet,activity,emo

2、tions,pain,position,gender,timeofdayanddiseasestates***UseofBirthControlPills****OverviewofBPStudiesofhealthypersonsshowthatbloodpressurecanfluctuatewithinawiderangeandstillbenormal.Itisimportanttoobtainseveralmeasurementsforcomparison.****Adiastolicelevationismoreserious

3、,reflectingpressureonarterialwallduringtherestingphaseofthecardiaccycle****ArterialBloodPressureRegulatedbyautonomicnervoussystem,kidneysandendocrineglandsNormalrangesfrom100/60to139/89Tendstoincreaseage,mostlikelyfromarterioscleroticandatheroscleroticchangesinbloodvessel

4、sorothereffectsofchronicdiseases.SystolicBPSystolicisdeterminedbytheforceandvolumeofbloodejectedfromleftventricleduringsystoleandtheabilityofarterialsystemtodistendatthetimeofcontractionSystolicBPThewallsofthearteriesarenormallyelastic&yieldtotheforce&volumeofventricularc

5、ontractionInolderPt’s,theSBPmaybeduetothelossofarterialelasticity(arteriosclerosis)SystolicBPNarrowingofthearterioles,eitherbyarteriosclerosisorsomeothermechanismthatcausesvasoconstriciton,peripheralresistance,whichinturnSBP.Thisresistanceiscomparedtothenarrowingofatub

6、e,suchasadrinkingstraworagardenhose.Thenarrowerthelumen,thethepressureneededtomoveairorliquidthroughit.DiastolicBPDiastolicreflectsarterialpressureduringventricularrelaxationanddependsuponresistanceofarteriolesandthediastolicfillingtimes.DiastolicBPIfarteriolesareresista

7、nt(constricted)bloodisundergreaterpressureHypertensiveDiseasePg.508HTN=sustainedofSBP>140orDBP>90orboth.HypertensiveDiseaseWhenacardiacabnormalityresultsfromelevatedBPthetermhypertensiveheartdiseaseisused.Whenvasculardamageispresentwithoutheartinvolvementthetermhypertens

8、ivevasculardiseaseisused.Whenbothheartdiseaseandvasculardamagetermhypertensivecardiovasculardise