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Cardiovascular > Atherosclerosis and Hypertension > Flashcards

Atherosclerosis and Hypertension Flashcards

1
Q

Atherosclerosis is a progressive disease characterised by what?

A

Build up of plaque in arteries

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2
Q

What is atherosclerotic plaque formed from?

A

Fatty substances, cholesterol, cellular waste, calcium and fibrin

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3
Q

What is essential hypertension?

A

No underlying cause

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4
Q

What is secondary hypertension?

A

Underlying cause

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5
Q

What are clinical complications of atheroma?

A

Stenosis, thrombosis, embolism, aneurysm, dissection, ischaemia

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6
Q

What has to happen for atherosclerosis to form, and what gets exposed?

A

Endothelial injury- exposes collagen

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7
Q

Following endothelial injury, what accumulates and what is produced?

A

Lipids and macrophages accumulate and cell adhesion molecules are produced

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8
Q

Because of production of adhesion molecules, what attaches to endothelial cells?

A

Monocytes and T lymphocytes

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9
Q

What do macrophages do during formation of atherosclerosis?

A

Take up oxidised LDL

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10
Q

What is the last stage of atherosclerosis formation?

A

Migration of smooth muscle and increase in size

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11
Q

What are atheromatous plaques formed from?

A

Fatty substances, cholesterol, cellular waste, calcium, fibrin

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12
Q

As plaques increase in size, what happens?

A

Compromised blood flow and damage to the arterial wall

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13
Q

What is the progression of atheroma?

A

Fatty streak, fibrofatty plaque, complicated plaque, plaque rupture

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14
Q

What can even the presence of a plaque (before rupture) cause?

A

Angina, TIA, claudication

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15
Q

What does the rupture of a plaque cause?

A

MI, stroke, critical leg ischaemia

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16
Q

When is atheromatous narrowing of an artery likely to produce critical disease?

A

If it is the only artery supplying an organ/tissue
The artery diameter is small
Overall blood flow is reduced

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17
Q

What are 5 complications of atheroma?

A

Stenosis, thrombosis, embolism, aneurysm, dissection

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18
Q

What is arterial stenosis?

A

Narrowing of the arterial lumen with reduced elasticity

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19
Q

What does arterial stenosis cause?

A

Reduced flow in systole and tissue ischaemia

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20
Q

What is cardiac fibrosis?

A

Loss of cardiac myocytes and replacement by fibrous tissue

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21
Q

What does cardiac fibrosis cause?

A

Loss of contractility, elasticity and filling

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22
Q

What is an aneurysm?

A

Abnormal and persistent dilatation of an artery due to a weakness in its wall

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23
Q

What is an arterial dissection?

A

Splitting of the media by flowing blood leading to a false lumen filled with blood

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24
Q

What factors influence high blood pressure?

A

Age, sex and race

25
Q

What is essential hypertension?

A

Rise in blood pressure of unknown cause

26
Q

What is hypertension classed as?

A

> 140/90

27
Q

What equation gives you BP?

A

CO x TPR

28
Q

What is salt sensitive hypertension?

A

Increase in dietary salt leads to increase in BP

29
Q

What is Conn’s syndrome?

A

Excess aldosterone

30
Q

What is Cushing’s syndrome?

A

Excess corticosteroid

31
Q

What is Pheochromocytoma?

A

Excess noradrenaline

32
Q

In benign hypertension, every 10mmHg above 85 does what?

A

Doubles risk of MI and stroke

33
Q

What does LVH lead to?

A

Increased LV load, poor perfusion, interstitial fibrosis, diastolic dysfunction

34
Q

What is classed as malignant hypertension?

A

Diastolic pressure 130-140

35
Q

What is pre-eclampsia?

A

Hypertension and proteinuria in pregnancy

36
Q

What can pre-eclampsia lead to?

A

Eclampsia (seizures) which is a medical emergency

37
Q

What should you offer if clinical BP is 140/90 or higher?

A

Ambulatory blood pressure monitoring to confirm diagnosis

38
Q

What is stage 1 hypertension?

A

Clinic BP 140/90 or higher and ABPM/HBPM average is 135/85 or higher

39
Q

What is stage 2 hypertension?

A

Clinic BP 160/100 or higher and ABPM/HBPM average is 150/95 or higher

40
Q

What is severe hypertension?

A

Clinic systolic BP 180 or higher and clinic diastolic BP is 110 or higher

41
Q

What is it known as when BP measures taken in clinic and at home are elevated?

A

Sustained hypertension

42
Q

What is known as when BP measured as normal in clinic and elevated at home?

A

Masked hypertension

43
Q

What is it known as when BP measured high in clinic and normal at home?

A

White coat hypertension

44
Q

What intervention should be offered for stage 1 hypertension?

A

Lifestyle interventions and support on adherence and annual review

45
Q

What intervention should be offered for stage 1 hypertension with target organ damage or high CV risk?

A

Offer drug treatment

46
Q

What intervention should be offered for stage 1 hypertension aged < 40?

A

Consider specialist referral

47
Q

What intervention should be offered for stage 2 hypertension?

A

Offer drug treatment

48
Q

What is the target BP of a person under 80?

A

140/90

49
Q

What is the target BP for a person aged 80+?

A

150/90

50
Q

People with WCH and aged < 80 should aim for ABPM of?

A

below 135/85

51
Q

People with WCH and aged 80+ should aim for ABPM of?

A

below 145/85

52
Q

What is the definition of WCH?

A

A discrepancy of more than 20/10 between clinic and average ABPM at time of diagnosis

53
Q

What are common causes of secondary hypertension?

A

Renal disease, obstructive sleep apnoea, aldosteronism

54
Q

What are uncommon causes of secondary hypertension?

A

Cushing’s, pheochromocytoma, hyperparathyroidism, aortic coarctation, intracranial tumour

55
Q

What are all the drugs which can be used for hypertension?

A

ACE inhibitor, ARB, Ca++ blocker, beta blocker, thiazide diuretic, spironolactone, alpha blocker

56
Q

What should be done if a persons hypertension is not controlled by ACE inhibitor, Ca++ blocker and thiazide diuretic?

A

Consider further diuretic, beta blocker, alpha blocker or seek expert advice

57
Q

What should be used for resistant hypertension?

A

Spironolactone

58
Q

What is classed as resistant hypertension?

A

Hypertension not controlled by spironolactone

Cardiovascular (23 decks)

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