N211: Health Differences Across the Lifespan I
Chapter One: Cardiovascu ar Probl ms Blood vessel compromise includes the following disease processes: hypertension, peripheral vascular disease, arteriosclerotic, heart disease, angina pectoris, gangrene and abdominal aortic aneurysm. 1.1 Hypertension Hypertension is a prolonged elevation of systolic and diastolic blood at or above 140 and the diastolic at or above 90 mm Hg. Primary hypertension (Essential) accounts for 90% of all cases and is thought to be caused by hormonal changes, hereditary factors, and other changes related to one’s lifestyle. Secondary hypertension is caused by another disease process, which if corrected, could correct the resulting hypertension. Blood pressure is created by the difference in the pressure of the blood as it leaves the heart and the resistance it meets flowing out to the tissues. Any factor that alters cardiac output or peripheral vascular resistance will alter blood pressure. Hypertension is a disease of the mechanisms of vascular regulation, primarily controlling the central nervous system, by the renal system (renin, angiotensin, and aldosterone) and by extracellular fluid volume. Blood pressure is elevated when the cardiac output is elevated, and the peripheral resistance is increased. Hypertension is known as the “silent killer” because of the 60 million Americans with virtually no symptoms. Risk Factors Non-modifiable risk factors are race (African American), age >30 and males. Modifiable risk factors are obesity, chronic emotional stress, elevated cholesterol levels, excessive sodium intake, tobacco, oral contraceptives and alcohol use. Associated conditions are coronary heart disease, heart failure, left ventricular hypertrophy and renal failure, peripheral vascular disease, cerebral vascular disease, stroke, nephropathy and retinopathy. Pharm cological History Use of steroids and estrogens will increase blood pressure. Signs and Symptom There are usually none; asymptomatic. Hypertension strains the heart and lungs and may result in left ventricular hypertrophy, failure, CHF or pulmonary edema.
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