Flashcards in Hypertension Deck (72)
What is the morphology of large/medium arteries?
degenerative changes in vascular walls
increase risk of aortic dissection and cerebovascular hemorrhage
What is the hypertension morphology of small arteries/arterioles?
What is hyaline arteriolosclerosis pathology?
similar changes in diabetics
homogenus pink thickening of vessels with narrow lumen
leakage of plasma across endothelium due to HTN
excess matrix production by smooth cells occurs secondarily
What are the histology of hyperplastic arteries?
characteristic of malignant htn
onion skinning laminated wall with luminal narrowing
-replication basement membrane and smooth muscle cells
What is necrotoizing arteriolitis?
malignant HTN; term used when these changes are associated with fibrinoid necrosis
What is the systemic HTN heart disease: morpoholgy?
cardiomegaly: concentric hypertrophhy without dilation
thickness of left ventricular wall impairs diastolic filling and causes left atrial enalrgment
myoccyte hypertrophy-- increased myocyte and nuclear enlargement
What are the direct arterial vasodilators?
What is the compensatory mechanism that reduces effectiveness of direct arterial vasodilators?
baroreceptor activation: compensatory increase in sympathetic outflow; tachyphylaxis can cause loss of antihyptertensive as well as reflex rellease ofrenin
What can be given with direct arterial vasodilators to counteract compensatory baroreceptor activation?
and diuretic for water retention
What is hypertensive urgency?
elevated Bp but no acute or progressing target organ injury
What is a hypertesnive emergency?
acute or progressing target organ damage from elevated BP
What are adverse effects of hydralazine?
lupus like syndrome
What are the general adverse effects of arterial vasodilators?
what is an adverse effect of minoxidil?
What are teh calcium channel blockers?
What are two alpha blockers?
phenoxybenzamine and phentolamine
What are teh effect of alpha blockers?
inhibit smooth muscle catecholamine uptake: vasodilation and BP lowering
What are the benefits of alpha1 selective blockers?
allow activation of alpha 2 and inhiiton of NE release; and don't stim renin release
and smaller increase in heart rate
What are the alpha 1 selective blockers?
What are the addverse effects of alpha1 blockers?
first dose effect
transient dizziness, faintness, palpitations, syncope
Where are hte Beta 1 receptors located?
heart and kidney, stimulate incrased HR, contractility and renin release
Where are beta 2 receptors located and what do they do?
lung, liver, pancrease, arteriolar smooth muscle
stim bronchodilation and vasodilation
mediate insulin secretion and glycogenolysis
What are the potential beta blockers adverse effects?
glucose intolerance, masked hypoglycemia
up TG and decrease HDL
CNS depression, fatigue, sleep disturbance
reduce CO, exacerbattion of herat failure
What are the central alpha2 agaonists?
What is tehmechansim of action of clonidine?
central alpha 2 agonist
-reduces sympathetic outflow from braint o vasomotor sensor
-increase vagal tone.
What are the adverse effects of cnetral alpha2 agaonists?
What is an adverse effect of clonididne?
anticholinergic side effects
What is an adverse effect of methyldopa
hepitisi or rarely hemolytic anemia
What are neuronal and ganglionic blockers used to treat HTN??