Aetiology and Pathophysiology of Systemic Hypertension

Question 1

what is hypertension?

Answer 1

the abnormal elevation of systolic and/or diastolic blood pressure

Question 2

how do we diagnose someone with hypertension?

Answer 2

repeat their BP reading:

• if they get BP of >140/90 mmHg and they’re <50yrs old or
• if they get BP of >160/95 mmHg and they’re >50yrs old
• then they may be hypertensive

Question 3

what is primary (essential) hypertension?

Answer 3

• when the cause is unknown

- can either be slowly progressive or rapid

Question 4

what is the proposed mechanism of primary hypertension?

Answer 4

1. renal excretion of sodium and water
2. baroreceptor sensitivity increases
3. renin is secreted stimulating vasoconstriction
4. causing increased blood pressure

Question 5

what is secondary hypertension?

Answer 5

when there is an underlying disease causing the raised BP (most common disease is renal disease)

Question 6

in hypertensive patients <40yrs old, what drives increased blood pressure?

Answer 6

high carbon monoxide though their total peripheral resistance (TPR) is normal

Question 7

in hypertensive patients >40yrs old, what drives increased blood pressure?

Answer 7

elevated total peripheral resistance though they have normal/reduced carbon monoxide levels.

Question 8

what is TPR (total peripheral resistance)?

Answer 8

-the amount of resistance to blood flow in the vascular system of the body. (so the amount of force working against the heart as it ejects blood)