Hypertension Flashcards
Define hypertension
BP = force of circulating blood against peripheral resistance
systolic - when heart contracts
diastolic - when heart is relaxed
Optimal = 100/60 - 135/85
HTN = 180/120 mmHg or higher
Essential vs Secondary hypertension
Essential/Primary - no specific underlying medical cause. Drivers: vascular resistance due to atherosclerosis, vasoconstriction, loss of blood vessel elasticity, inc. blood viscosity, obesity, stress, anxiety, smoking, high salt
Secondary - diseases of kidneys, adrenals, thyroid, diabetes.
Malignant HTN - above 180/120: medical emergency
Hypertension causes and risk factors
Genetics
Obesity
Excess alcohol
Stress
Nutritional deficiencies
high table salt intake - and/or low potassium
Inactivity
Smoking and drugs
Raised uric acid
What’s genetic role in HTN
genetic link/ED impairment
What role does obesity play in HTN
abdominal adiposity - activated RAAS causing vasoconstriction and water retention.
What role does alcohol play in HTN
lowers baroreceptor reflex (ability to respond to BP changes), by interacting with receptors in brain stem
increased sympathetic outflow, heart rate and BP
stimulates ED to release vasoconstrictors
activates RAAS.
What role does stress play in HTN
SNS activity, causes vasoconstriction.
High cortisol increases vasoconstrictor ET-1
activates RAAS.
Nutritional deficiencies in HTN
Mg
Potassium (inc. urinary excretion of sodium).
What role does inactivity have in HTN
associated with higher heart rate, greater force on arteries (inc. cardiac contractility)
What role do smoking and drugs have in HTN
NSAIDS, corticosteroids (flood body with cortisol).
What role does raised uric acid have in HTN
stimulates RAGE pathway which inc. NF-KB
disrupts eNOS activity
exacerbates endothelial insulin resistance
lowers NO.
