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Cardiovascular block > Aetiology of hypertension > Flashcards

Aetiology of hypertension Flashcards

1
Q

What is hypertension ?

A

Is that blood pressure at which the benefits of treatment with antihypertensive agents in reducing cardiovascular , cerebrovascular and peripheral vascular risk outweigh the risks of treatment

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2
Q

When does someone have hypertension ?

A

140/90mmHg

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3
Q

What is the number 1 cause of preventable morbidity and mortality ?

A

Hypertension

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4
Q

What is the % increase risk mortality from IHD ?

A

7%

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5
Q

What is the % increase risk mortality from stroke ?

A

10%

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6
Q

What is the epidemiology of hypertension ?

A

affects 30-40% of the adult population

Prevalence >65% in persons over 60yrs

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7
Q

What are the risk factors for hypertension ?

A

MI
HF
Stroke
CVD

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8
Q

What does cigarette smoke do to BP ?

A

Adds 20/10mmHg

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9
Q

How much more times are males at risk ?

A

2X

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10
Q

How much more times are LVH at risk ?

A

2X

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11
Q

What are the most common causes of death due to raised blood pressure ?

A

Ischemic heart disease and stroke

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12
Q

What end organ damage is associated with hypertension ?

A 
LVH, CHD, CHF, MI
Renal failure, dialysis, transplantation, proteinuria
Peripheral vascular disease
Retinopathy
Stroke
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13
Q

What is the defined as stage 1 hypertension ?

A

Clinical BP is 140/90mmHg or higher

ABPM daytime average 135/85mmHg or higher

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14
Q

What is defined as stage 2 hypertension ?

A

Clinic BP is 160/100mmHg or higher

ABPM daytime average 150/95mmHg or higher

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15
Q

What is defined as stage 3 or severe hypertension ?

A

Clinic systolic BP is 180/120mmHg or higher

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16
Q

What is primary hypertension ?

A

in 80-90% no cause can be found ?

17
Q

What is secondary hypertension ?

A

In 10-20% a cause can be found ?

18
Q

What are some of the causes of secondary hypertension ?

A

Chronic renal disease
Renal artery stenosis
Endocrine disease, Cushing’s

19
Q

How is BP controlled ?

A

By an integrated system

20
Q

What are the prime contributors to BP ?

A

Cardiac output
Stroke volume and heart rate
Peripheral vascular resistance
Each of these factors can be manipulated by drug therapy

21
Q

The sympathetic NS activation produces what ?

A

Vasoconstriction - increases resistance
Reflex tachycardia
Increased stroke volume - increased cardiac output

22
Q

What else does the sympathetic NS stimulate ?

A

Stimulates renin release which produces angiotensin II and aldosterone

23
Q

What is the renin-angiotensin-aldosterone system responsible for ?

A

Maintenance of sodium balance
Control of BP
Control of blood volume

24
Q

What is the renin-angiotensin-aldosterone system stimulated by ?

A

Fall in BP
Fall in circulating volume
Sodium depletion

25
Q

What is the aetiology of hypertension ?

A 
Polygenic:
    - major genes
    - poly genes
Polyfactorial:
    - environment
    - individual and shared
26
Q

What does increased reactivity of resistance vessels result in ?

A

Increase in peripheral resistance

27
Q

What is the sodium homeostatic effect ?

A

In hypertensive individuals the kidneys are unable to excrete appropriate amounts of sodium for any given BP, as a result sodium and fluid are retained and the BP increases

28
Q

How does age contribute to hypertension ?

A

BP rises with age possibly as a result of decreased arterial compliance
We must be pragmatic, the elderly are more susceptible to adverse effects

29
Q

How does genetics and family history contribute to hypertension ?

A

A history of hypertension tends to run in families

Between siblings rather than parents and child

30
Q

How does environmental factors contribute to hypertension ?

A

Mental and physical stress both increases blood pressure

Removing stress does nor nescesaarlily return BP to normal values

31
Q

How does salt intake and diet contribute to hypertension ?

A

Reducing salt intake in hypersensitive individuals to <5gm/day or 1.5/day

32
Q

How does alcohol contribute to hypertension ?

A

Affects 1% of population
Small amounts of alcohol decrease BP
Large amounts of alcohol increase BP

33
Q

How does weight contribute to hypertension ?

A

Obese pateints have a higher BP

Up to 30% of hypertension is attributable in part of wholly to obesity

34
Q

How does race contribute to hypertension ?

A

Caucasians have lower BP than African populations

Cardiovascular block (28 decks)

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