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Related Concept Videos

Hypertension I: Introduction01:28

Hypertension I: Introduction

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Hypertension is a widespread, long-term medical condition where blood pressure in the arteries remains elevated. It is characterized by systolic blood pressure readings of 130 mm Hg or above or diastolic blood pressure (DBP) readings of 80 mm Hg or higher. Unmanaged hypertension poses significant health risks, making the distinction between primary (or essential) hypertension and secondary hypertension crucial, as their management and implications vary.Primary HypertensionPrimary hypertension,...
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Hypertension II: Pathophysiology01:29

Hypertension II: Pathophysiology

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Hypertension is a chronic condition in which the blood's force against artery walls is excessively high, posing risks such as heart disease. The condition's underlying mechanisms involve complex interactions among the cardiovascular, kidney, and autonomic nervous systems.Renin-Angiotensin-Aldosterone System (RAAS): This system significantly influences blood pressure regulation. When blood pressure decreases, the kidneys secrete renin. This enzyme transforms angiotensinogen, a plasma protein,...
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Hypertension V: Nursing Management01:23

Hypertension V: Nursing Management

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The nursing management of hypertension involves accurately assessing symptoms, making a comprehensive nursing diagnosis, collaborating with patients to set goals, and implementing targeted interventions to mitigate the condition's impact and improve patient well-being.Comprehensive AssessmentThe initial step in nursing care for hypertension involves a thorough patient assessment. It includes evaluating symptoms such as headaches, dizziness, blurred vision, and previous hypertension episodes.
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Hypertension and Regulation of Blood Pressure01:18

Hypertension and Regulation of Blood Pressure

4.5K
Hypertension, the most common cardiovascular disease, is diagnosed through repeated measurements of elevated blood pressure. Its risks, including damage to the kidney, heart, and brain, are directly proportional to blood pressure levels. Starting from 115/75 mm Hg, the risk of cardiovascular disease doubles with each increment of 20/10 mm Hg. The diagnosis relies on blood pressure measurements, not on patient symptoms, as hypertension is often asymptomatic until end-organ damage is imminent or...
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Pulmonary Hypertension: Classification and Pathogenesis01:30

Pulmonary Hypertension: Classification and Pathogenesis

664
Pulmonary hypertension (PH) is a severe health condition in which the mean pulmonary arterial pressure increases to 25 mmHg or more, even when the body is at rest. This high pressure in the blood vessels that transport blood from the heart to the lungs can cause various symptoms, including shortness of breath, can lead to right heart failure, and significantly affect the overall quality of life.
There are various classifications for PH, each relating to different underlying causes and also...
664
Hypertension III: Clinical Manifestations and Diagnostic Studies01:30

Hypertension III: Clinical Manifestations and Diagnostic Studies

602
Hypertension is asymptomatic and also referred to as the "silent killer" until it progresses to a severe stage or causes target organ disease. Patients may experience symptoms stemming from the strain on blood vessels and tissues in various organs or the heart's increased workload.Physical exams might show no abnormalities other than high blood pressure. Signs of vascular damage, when present, correspond to the organs supplied by the affected vessels, leading to target organ damage. For...
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Evaluation of Right Ventricular Function in Experimental Models of Pulmonary Arterial Hypertension
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Hypertension Update: Resistant Hypertension.

Anthony J Viera1

  • 1Department of Community and Family Medicine Duke University School of Medicine, Box 2914 DUMC, Durham, NC 27710.

FP Essentials
|June 5, 2018
PubMed
Summary
This summary is machine-generated.

Resistant hypertension, uncontrolled blood pressure despite medication, requires careful evaluation for adherence and secondary causes. Management involves lifestyle changes, diuretics, and often a four-drug regimen, with specialist referral if needed.

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Hemodynamic Characterization of Rodent Models of Pulmonary Arterial Hypertension
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Area of Science:

  • Cardiology
  • Nephrology
  • Pharmacology

Background:

  • Resistant hypertension is defined as blood pressure (BP) remaining above goal despite adherence to three or more antihypertensive drugs, including a diuretic.
  • Accurate diagnosis requires confirming medication adherence and ruling out white coat hypertension via out-of-office BP monitoring.
  • Factors like obesity, alcohol, and interfering substances can contribute to resistant hypertension.

Purpose of the Study:

  • To outline the diagnostic evaluation and management strategies for patients with suspected resistant hypertension.
  • To emphasize the importance of adherence, lifestyle modifications, and identifying secondary causes.
  • To detail appropriate pharmacologic approaches, including diuretic therapy and add-on medications.

Main Methods:

  • Confirming patient adherence to prescribed antihypertensive medications.
  • Utilizing out-of-office BP measurements, such as 24-hour ambulatory BP monitoring, to exclude white coat hypertension.
  • Investigating potential secondary causes of hypertension, including kidney disease, obstructive sleep apnea, and hyperaldosteronism.
  • Implementing lifestyle modifications such as exercise and sodium restriction.
  • Optimizing pharmacotherapy with a diuretic, a dihydropyridine calcium channel blocker, an ACE inhibitor or ARB, and potentially spironolactone or other agents.

Main Results:

  • Adequate diuretic therapy is fundamental to managing resistant hypertension.
  • A four-drug regimen, including a diuretic, dihydropyridine calcium channel blocker, ACE inhibitor/ARB, and spironolactone, is often effective.
  • Referral to a hypertension subspecialist is recommended when BP remains uncontrolled on a four-drug regimen.

Conclusions:

  • Comprehensive evaluation and tailored management are crucial for resistant hypertension.
  • Adherence, lifestyle, and addressing secondary causes are key components of treatment.
  • Pharmacological intensification, guided by specialist input when necessary, is essential for achieving BP control.