A 5\'6\", 210 pound, 64 year old man had a physical exam prior to his retirement

Question

A 5'6", 210 pound, 64 year old man had a physical exam prior to his retirement for corporate work. His blood pressure was greater than 180/115 mmHg on three separate days (normal blood pressure is 120/80). Further examination showed normal to low plasma renin activity, elevated peripheral resistance (PR), x-ray showed left ventricular hypertrophy and retinal hemorrhage and cardiac output was 7.2 L/min (normal is 3.5 to 5.5 L/min). Recommended therapy was weight reduction to his ideal weight, low salt diet. If these life style changes did not change his condition the following medication will be started in the following order: oral diuretics progress to beta blockers and then to a vasodilator.

1-Define after load and preload, which one is increased in this patient; explain your answer

Explanation / Answer

PRELOAD

AFTERLOAD

The patient has HYPERTENSION ( elevated blood pressure ) which increases the left ventricular ( LV ) afterload because-

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