Hypertension

Hypertension

  • Hypertension, or high blood pressure (BP), is one of the most important modifiable risk factors that can lead to the development of cardiovascular disease (CVD).
  • As BP increases, so does the risk of
    • MI, Heart failure, Stroke and Renal disease
  • Affects 1 in 3 adults in United States
  • High priority health concern identified in Healthy People 2020
  • 83% of people > age 20 with hypertension are aware they have high BP
    • 76% are being treated
    • 48% of those aware do not currently have their BP well controlled
  • Blood pressure (BP) is the force exerted by the blood against the walls of the blood vessel.
  • BP is primarily a function of cardiac output (CO) and systemic vascular resistance (SVR)
  • Systemic vascular resistance (SVR) is the force opposing the movement of blood within the blood vessels

Factors affecting BP

Blood pressure = Cardiac output X Systemic vascular resistance

  • Cardiac output
    • Cardiac
      • Heart rate
      • Contractility
      • Conductivity
    • Renal fluid volume control
      • Renin-angiotensin-aldosterone system
      • Natriuretic peptides
  • Systemic vascular resistance
    • Sympathetic nervous system
      • α1– and α2-Adrenergic receptors (vasoconstriction)
      • β2-Adrenergic receptors (vasodilation)
    • Local regulation
      • Vasodilators
        • Prostaglandins
        • Nitric oxide
      • Vasoconstrictors
        • Endothelin
    • Neurohormonal
      • Vasoconstrictors
        • Angiotensin
        • Norepinephrine