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CVD > 1. Hypertension > Flashcards

1. Hypertension Flashcards

1
Q

What BP is indicative of stage 1 hypertension?

A

140/90

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2
Q

What BP is indicative of stage 2 hypertension?

A

160/100

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3
Q

What BP is indicative of stage 3 hypertension?

A

180/110

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4
Q

How is BP calculated?

A

CO x peripheral resistance

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5
Q

What factors control CO?

A

Na+, mineralocorticoids, ANP

HR and contractability

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6
Q

Name 3 factors that influence vasoconstriction

A

a-adrenergic receptors
angiotensin
catecholamines

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7
Q

Name 4 factors that influence vasodilation

A

B-adrenergic receptors
Prostaglandins
Kinins
NO

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8
Q

What are the risk factors for hypertension?

A 
High BMI
Salt intake
Alcohol, smoking
Inactivity
Genetics
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9
Q

What is hypertension with an unknown cause called?

A

Essential hypertension

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10
Q

Why does Cushing’s syndrome increase the risk of hypertension?

A

High cortisol increases sensitivity of blood vessels to adrenaline and noradrenaline, both of which are vasoconstrictors

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11
Q

What are the functions of angiotensin 2?

A

Vasoconstriction and the release of aldosterone which causes Na retention

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12
Q

Where is angiotensinogen produced?

A

Liver

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13
Q

What enzyme converts angiotensinogen to angiotensin 1?

A

Renin

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14
Q

Why does COVID-19 cause vasoconstriction?

A

Turns off ACE-2 which converts angiotensin 2 to angiotensin 1-7
Angiotensin 1-7 have the effects of vasodilation and increasing NO

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15
Q

Why does Conn’s syndrome increase the risk of hypertension?

A

Increased aldosterone causes an increase in sodium retention

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16
Q

What are the causes of secondary hypertension?

A 
Renal 
Adrenal
Pituitary acromegaly eg. pregnancy
CV eg. coarctation of aorta
Alcohol and cocaine
Increased ICP (cushing's response)
17
Q

What are the adrenal causes of hypertension?

A 
Excess aldosterone (conn's syndrome)
Catecholamine excess
18
Q

What causes Conn’s syndrome?

A

Hyperplasia or tumours of zona glomerulosa

19
Q

What type of tumour causes a catecholamine excess?

A

Phaeochromocytoma

20
Q

What type of hypertension is associated with phaeochromocytoma?

A

Paroxysmal

21
Q

What are the endocrine causes of hypertension?

A

Thyroid over or under function
Pituitary tumour
Pre-eclampsia

22
Q

What is pre-eclampsia and how does it cause hypertension?

A

Placental ischaemia causes the placenta to produce renin

23
Q

How can hypertension be investigated?

A

Urinalysis
Bloods: glucose, lipids, U&Es
Fundoscopy
ECG

24
Q

What is fundoscopy?

A

Examination of blood vessels of the retina

25
Q

What can be seen on an ECG in hypertension?

A

LV hypertrophy seen as a larger QRS complex

26
Q

What are the vascular consequences of hypertension?

A

Smooth muscle hypertrophy in media
Fibrosis and loss of elastic tissue can cause dissection and rupture berry aneurysms
Accelerated atherosclerosis
Luminal narrowing in kidney causes renal impairment

27
Q

What is malignant hypertension?

A

> 120 diastolic BP

28
Q

What does malignant hypertension cause?

A

Fibrinoid necrosis of vessels

This causes thrombosis and haemolytic anaemia (see forum)

29
Q

What are the consequences of malignant hypertension?

A

Acute renal failure
Encephalopathy
Increase ICP

30
Q

What are the cardiac consequences of hypertension?

A 
LV hypertrophy (leading to an MI due to underperfusion)
Sustained LV hypertrophy can cause dilatation which causes heart failure due to loss of pump function
31
Q

What are the renal consequences of hypertension?

A

Nephrosclerosis (risk increased with other small vessel diseases)
Lack of perfusion triggers RAAS and worsens BP

32
Q

What are the cerebrovascular consequences of hypertension?

A

Stroke

Rupture of pre-existing berry aneurysm

CVD (22 decks)

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