CVS 14 - Hypertension

Question 1

What is the threshold for hypertension?

Answer 1

140/90 mmHg

Question 2

How does blood pressure change with age?

Answer 2

Systolic increases fairly linearly
Diastolic plateaus and then decreases
The difference between systolic and diastolic increases

Question 3

What is the difference between primary and secondary hypertension? Which one is more common?

Answer 3

Primary/Essential Hypertension - has no known cause (95% of all hypertension)
Secondary Hypertension - has an underlying cause

Question 4

Give some examples of secondary hypertension.

Answer 4

Renal Artery Stenosis
Conn’s Syndrome (inappropriate secretion of aldosterone)
Pheochromocytoma (tumour of the adrenal medulla causing increased production of catecholamines)
Oral Contraceptive Pill
Liddle’s Syndrome (genetic - less than 1%)

Question 5

Give some lifestyle risk factors of hypertension.

Answer 5

Obesity, Smoking, Alcohol, Salt Intake

Question 6

What part of the CO = MABP/TPR equation is most affected in hypertension?

Answer 6

There is an increase in TPR caused by decreased arterial compliance
Normal cardiac output
Normal blood volume

Question 7

State three causes of an increase in TPR.

Answer 7

Active narrowing of arteries - vasoconstriction
Structural narrowing of arteries - due to remodelling
Loss of capillaries - leads to increased pressure so leakage and impaired perfusion

Question 8

What organ has a major influence on hypertension?

Answer 8

Kidneys - hypertension is strongly associated with impaired renal flow and blood flow

Question 9

What is congestive heart failure?

Answer 9

The inability of the heart to adequately pump blood at normal filling pressures.

Question 10

What can hypertension do to large arteries?

Answer 10

Arterial hypertrophy
Promote atherosclerosis
Aneurysms - thrombosis and haemorrhage

Question 11

What does hypertension do to the microvasculature?

Answer 11

Hypertension causes a decrease in capillary density and a subsequent elevation of capillary blood pressure

Question 12

What becomes present in the urine in hypertensive people?

Answer 12

The kidneys are a target for damage due to hypertension. It leads to renal dysfunction leading to the presence of albumin in the urine (microalbuminuria). The concentration of albumin in the urine is proportional to the systolic blood pressure.

Question 13

Give 5 physiological impacts of HT

Answer 13

1. Structural remodelling of the heart - LV wall thickens
2. Hypertrophy of arteries and remodelling - increases atherosclerosis
3. Stress on walls which leads to aneurysms
4. Damage retinal microvasculature leading to retinopathy
5. Renal damage - albumin loss in urine