Pathology- Hypertension Flashcards
(43 cards)
what is hypertension
a disorder in which the level of sustained arterial pressure is higher than the expected for the patient (age, sex and race)
why are repeat measurements important
normal variation throughout day,
white coat hypertension,
stable or labile (fluctuates in response to e.g. emotional stress) hypertension
what does hypertension ultimately cause
cardiac failure
what is hypertension a risk factor for
cerebral haemorrhage,
atheroma,
renal failure,
sudden cardiac death
what is essential in the prevention of risk factors associated with hypertension
early detection and treatment
how does the incidence of hypertension vary
varies between countries, ethnic groups, genetic link, rises with age
what are the aetiological classifications of hypertension (according to cause)
primary (no underlying cause, genetics = environment)
secondary (underlying disease)
what are the classifications of hypertension depending on consequences
benign- often primary
malignant- often secondary, extreme kills quickly
how is blood pressure tested
CO x TPR
what affects CO
HR, contractility, blood volume
what affects peripheral resistance
constrictors (angiotensin II, catecholamines)
dilators (nitric oxide, prostaglandins)
what is the primary site of resistance
end arterioles
when is renin released by the kidneys
when renal blood flow increases
when is ACE found
the lungs
how does angiotensin 2 increase blood pressure
by vasoconstriction and by increasing blood flow
hoe does agiotensin 2 increase blood flow
aldosterone release (salt and fluid retention)
how do ACE inhibitors reduce blood flow
stop conversion of angiotensin 1 to angiotensin 2
what is salt sensitive hypertension and how is it controlled
increase in dietary salts leads to increase in BP
controlled by reduction in salt in diet
what conditions can cause secondary hypertension
Renal disease Endocrine disease Aortic disease Renal artery stenosis Drug therapy
hoe can renal diseases cause high BP
reduced renal blood flow
excess renin release
salt and water overload
what renal diseases can cause secondary hypertension
renal artery stenosis, acute or chronic glomerulonephritis, chronic pyelonephritis, cystic diseases, interstitial nephritis
describe the layers of the adrenal cortex
3 layers, each producing different thing (aldosterone, steroid hormone (corticosteroid), noraldrenaline (adrenal medulla))
what are the endrocrine causes of secondary hypertension
Adrenal gland hyperfunction / tumours
Conn’s syndrome - excess Aldosterone Cushing’s syndrome - excess corticosteroid Phaeochromocytoma - excess noradrenaline
what is coarctation of the aotra
congenital narrowing of segments of the aorta (causes paradoxical hypertension- high in upper body, lower in legs)
