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Systems 2: Cardiovascular > Hypertension > Flashcards

Hypertension Flashcards

1
Q

Facts on hypertension

A
  • World’s number 1 cause of preventable and premature mortality and morbidity - A 2mmHg rise in BP causes a 7% increase of mortality from IHD and a 10% increased risk of mortality from stroke
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2
Q

What does hypertension greatly contribute to?

A

End organ damage

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3
Q

What conditions can be easily developed due to hypertension?

A
  • IHD - Retinopathy - Peripheral vascular disease - Stroke - CHD - Heart failure - Renal failure - Proteinuria
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4
Q

How many times greater is your risk of stroke if you are hypertensive compared to normal blood pressure?

A

4-6 times greater

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5
Q

What ways can blood pressure vary throughout the day?

A
  • Physical stress - Mental stress
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6
Q

What is the definition of clinical hypertension?

A

The blood pressure at which the benefits of treatment outweigh the risks in terms of morbidity and mortality

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7
Q

Describe what is shown here

A

Shows blood pressure distribution between different cultures

  • Group 1 = island dwellers in the pacific where BP is lower
  • Group 5 shows western european BP
  • Notice all follow an equal distribution within their populations
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8
Q

How does age affect hypertension?

A

As age increases BP increases

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9
Q

What is the correlation between high BP and risk of stroke and CHD?

A

As BP increases the chances of developing these increases

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10
Q

Which age decade has the biggest increase in IHD mortality compared to average blood pressure at the beginning of that decade?

A

40 - 49 years

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11
Q

What is stage 1 hypertension?

A
  • Clinical blood pressure > 140/90mmHg
  • ABPM (ambulatory blood pressure monitoring) average of >135/85
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12
Q

What is stage 2 hypertension?

A
  • BP > 160/100mmHg
  • ABPM average > 150/95mmHg
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13
Q

What is severe hypertension?

A
  • Systolic > 180
  • Diastolic > 110
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14
Q

What other factors also increase the risk of hypertension?

A
  • Smoking
  • Diabetes
  • Renal disease
  • Being a bloke
  • Hyperlipidaemia
  • Previous history of MI or stroke
  • Left ventricular hypertrophy (PHT)
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15
Q

What three ways is the renin-angiotensin-aldosterone system activated?

A
  • Fall in BP
  • Fall in circulating volume
  • Lack of sodium in blood
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16
Q

What can angiotensin II also cause (instead of the release of aldosterone from the adrenal glands)?

A

Myocyte hypertrophy

17
Q

What are the polygenic aetiologies of hypertension?

A
  • Major genes (very rare)
  • Poly genes
18
Q
A
19
Q

What is meant that hypertension is polyfactorial?

A
  • Can be influenced by multiple environmental factors
  • Can be individual or shared (people sharing the same diet etc may be both hypertensive)
20
Q

What are example of individual hypertension aetiologies?

A
  • Oral contraceptives
  • Physical inactivity
  • Stress
  • Lower education
  • Small family size
21
Q

What are the most likely causes (endogenous) of hypertension?

A
  • Increased reactivity of resistance vessels increase TPR
  • Sodium homeostatic effect (kidneys unable to excrete appropriate sodium levels so sodium and fluid retained and BP increases
22
Q

How should hypertension in the elderly be treated?

A
  • Aggressively
  • They have more to lose
  • MUST REMAIN PRAGMATIC
23
Q

Is hypertension hereditary?

A
  • Yes
  • Tends to run in the family (or in a hypertensive family no one runs haha haaaaaa)
  • Closest correlation between siblings rather than parent to child
24
Q

What special type of siblings very commonly both have hypertension or both don’t

A
  • Monozygotic twins
  • Dizygotic do show a correlation though not as strong
25
Q

What is the correlation between sodium and hypertension?

A

More salt in the diet the higher the BP

26
Q

What is the correlation between potassium in the diet and hypertension?

A

More potassium, lower blood pressure

27
Q

What is the most common cause of hypertension in a young scottish person?

A

Alcohol

28
Q

What percent of the population are affected by hypertension caused by alcohol?

A

1%

29
Q

What will the effects of small amounts of alcohol have on the BP?

A

Tend to actually lower it

30
Q

What percentage of hypertension is attributable to being obese?

A

30%

31
Q

Why does obesity increase blood pressure?

A
  • Releases interleukin-6 which increase BP
  • Activates sympathetic system more often
  • Also related to sleep apnoea so increases hypertension
32
Q

What is the correlation between birth weight and hypertension later in life?

A

Higher the birth rate the lower the BP

33
Q

What is secondary hypertension?

A

Unknown cause

34
Q

What is responsible for 20% of resistant hypertensions?

A

Renal disease

35
Q

What renal diseases can cause hypertension?

A
  • Chronic pyelonephritis (inflammation and fibrosis from repeat infection
  • Fibromuscular dysplasia (a non atherosclerotic or fibrotic growth in the blood vessels most commonly in renal and carotid
  • Renal artery stenosis (narrowing of renal arteries)
  • Polycystic kidneys
36
Q

What drugs can increase BP?

A
  • NSAIDs
  • Oral contraceptive
  • Corticosteroids
37
Q

What can pregnancy cause that affects BP?

A
  • Preeclampsia (hypertension during pregnancy)
38
Q

What endocrine conditions can affect BP?

A
  • Conn’s Syndrome (excess aldosterone)
  • Cushings Disease (excess cortisol)
  • Phaeochromocytoma (tumour on adrenal resulting in excess epinephrine)
  • Hypo/hyperthyroidism
  • Acromegaly (too much HGH)
39
Q

What vascular change can increase BP?

A

Aortic Coarctication

Systems 2: Cardiovascular (19 decks)

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