peripheral vascular resistance


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Related to peripheral vascular resistance: Total peripheral resistance

hypertension

High blood pressure Cardiovascular disease An abnormal ↑ systemic arterial pressure, corresponding to a systolic BP of > 160 mm Hg and/or diastolic BP of 95 mm Hg and graded according to intensity of ↑ diastolic BP; HTN affects ± 60 million in the US Workup Evaluation of HTN requires clinical Hx for Pt, family Hx, 2 BP determinations, funduscopy, ID of bruits in neck & abdominal aorta, evaluation of peripheral edema, peripheral pulses and residual neurologic defects in stroke victims, chest films to determine cardiac size and lab parameters to rule out causes of secondary HTN Risk factors Race–blacks more common, ♂, family history of HTN, obesity, defects of lipid metabolism, DM, sedentary lifestyle, cigarette smoking, electrolyte imbalance–eg, ↑ sodium, phosphorus, ↓ potassium, tin Treatment Diet–eg, sodium restriction, ↓ calories, alcohol and cigarettes–the weight gain accompanying smoking cessation tends to offset the minimal ↓ in BP, calcium supplements, lifestyle manipulation–eg, biofeedback, ↑ exercise; antihypertensives–eg, diuretics–benzothiadiazines, loop diuretics, potassium-sparing diuretics, sympatholytic agents–central and peripheral-acting α-adrenergics, β-adrenergics, mixed α- and β-blockers, direct vasodilators, ACE inhibitors–the preferred agent to use ab initio, dihydropiridine CCBs. See ACCT, ACE inhibitor, Borderline hypertension, Borderline isolated systolic hypertension, Calcium channel blocker, Drug-induced hypertension, Essential hypertension, Exercise hypertension, Familial dyslipemic hypertension, Gestational hypertension, Idiopathic intracranial hypertension, Isolated systolic hypertension, Malignant hypertension, MRC, Obetension, Paradoxic hypertension, Pill hypertension, Pregnancy-induced hypertension, Pseudohypertension, Pulmonary hypertension, Refractory hypertension, Renovascular hypertension, SHEP, STOP-Hypertension, TAIM, TOHP-1, TOMHSTyramine hypertension, White coat hypertension.
Hypertension
Class I–mild Diastolic pressure 90-104 mm Hg
Class II–moderate Diastolic pressure 105-119 mm Hg
Class III–severe Diastolic pressure > than 120 mm Hg
Hypertension types
Essential hypertension Idiopathic HTN The major form comprising 90% of all HTN
Malignant hypertension A sustained BP > 200/140 mm Hg, resulting in arteriolar necrosis, most marked in the brain, eg. cerebral hemorrhage, infarcts, and hypertensive encephalopathy, eyes, eg papilledema and hypertensive retinopathy and kidneys, eg acute renal failure and hypertensive nephropathy; if malignant HTN is uncorrected or therapy refractory, Pts may suffer a hypertensive crisis in which prolonged high BP causes left ventricular hypertrophy and CHF
Paroxysmal hypertension Transient or episodic waves of ↑ BP of any etiology, punctuated by periods of normotension, typical of pheochromocytoma
Portal hypertension ↑ portal vein pressure caused by a backflow of blood through splenic arteries, resulting in splenomegaly and collateral circulation, resulting in esophageal varices and/or hemorrhoids; PH may be intra- or extrahepatic, and is often due to cirrhosis, or rarely portal vein disease, venous thrombosis, tumors or abscesses
Pulmonary hypertension A condition defined as a 'wedge' systolic/diastolic pressure > 30/20 mm Hg–Normal: 18-25/12-16 mm Hg, often secondary to blood stasis in peripheral circulation, divided into passive, hyperkinetic, vasoocclusive, vasoconstrictive and secondary forms. See Pulmonary HTN.
Renovascular hypertension see there.
Secondary hypertension
Aging
Cardiovascular Open heart surgery, coarctation of aorta, ↑ cardiac output–anemia, thyrotoxicosis, aortic valve insufficiency
Cerebral ↑ Intracranial pressure
Endocrine Mineralocorticoid excess, congenital adrenal hyperplasia, glucocorticoid excess, eg Cushing syndrome, hyperparathyroidism, acromegaly
Gynecologic Pregnancy, oral contraceptives
Neoplasia Renin-secreting tumors, pheochromocytoma
• ↓ Peripheral vascular resistance AV shunts, Paget's disease of bone, beri-beri
Renal disease Vascular, parenchymal
McGraw-Hill Concise Dictionary of Modern Medicine. © 2002 by The McGraw-Hill Companies, Inc.
References in periodicals archive ?
For patients presenting angina pectoris, TENS, when applied on the precordial region at high frequencies (150 and 70 Hz), diminishes peripheral vascular resistance and arterial systolic pressure (7) by reducing serum levels of adrenalin (3,7) and noradrenalin (7) and increasing coronary blood flow, suggesting that these alterations occur at the microcirculation level (3).
This algorithm does not require calibration because the conversion factor autocorrects for changing peripheral vascular resistance [20].
Previous epidemiologic studies have reported that peripheral vascular resistance and systemic blood pressure were elevated in populations that had ingested the arsenic-contaminated drinking water (Chen and Yen 1964; Tseng et al.
Norepinephrine levels and peripheral vascular resistance did not change despite the marked increase in blood pressure.
A decrease in peripheral vascular resistance and in diastolic blood pressure may also be related to enhanced NO production and has been found in hypothyroid patients treated with thyroxine (23-25).
The use of cardioselective [beta]-blockers during pregnancy has been associated with IUGR, which is thought to be related to increased peripheral vascular resistance in the mother and the fetus.

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