Question

1. Physiology of blood pressure and cardiac output

2. Complication of hypertension and heart failure including prevention

Answer 1

Physiology of cardiac output
Cardiac output is the volume of blood ejected by ventricles during each heart beat .
Cardiac output =Heart rate x stroke volume
SO Increase in heart rate or stroke volume will incraese the cardiac output

Blood pressure is the pressure exerted on lateral walls of blood vessels
It has two components
Systolic Bp dependend on Cardiac output
Increase in cardiac output increase systolic Bp
Diastolic Bp depends on Peripheral vascular resistance so Vasoconstriction increase Diastolic bp
Pulse pressure = Systolic Bp - Diastolic Bp
Mean arterial pressure = Diastolic Bp + 1/3 rd pulse pressure

Regulation of Bp
1.Chemical regulation
Vasoconstrictor increase Bp
Vasodilator decrease BP
2. Neural / short term regulation by Baroreceptors chemoreceptors and Cns ischaemic response
3. Intermediate term regulation
ADH(Antidiuretic hormone) and thirst
ANP atrial natriuretic peptide
4 .Long term
Kidneys

Complications of heart failure and HTN

Target organ damge is seen

1.Brain - Stroke ( Cerebrovascular accident ) and Hypertensive encephalopathy
2.Heart - Heart attack ( Myocardial infarction ) and Hypertensive cardiomyoathy and heart failure .
3.Eyes - Hypertensive retinopathy
4.Kidneys - Hypertensive nephrpathy and chronic kidney disease .
5.Blood - Hyperglycaemia .

Similarly complications of Heart failure :

1.Chronic kidney disease

2.Heart valve related problems

3.Heart rhythm problems. Heart rhythm problems (arrhythmias) can be a potential complication of heart failure.

4.Liver damage. Right sided Heart failure can lead to a buildup of fluid that puts too much pressure on the liver.

Prevention for heart failure and HTN
Appropriate antihypertensive should be started with adequate control Of Bp
Dietary modification
Salt restriction in diet
Daily aerobic exercises
Avoid fast foods fatty substances to decrease cholesterol and triglycerides on blood
Avoid smoking and alcohol
Weight loss and adequate sleep