End-organ damage and secondary HTN Flashcards
What end-organ damage can HTN cause?
- Retinopathy
- Cerebrovascular disease
- CVD
LVH
IHD
HF - Nephropathy
What is the grading of retinopathy?
- Torturous arteries with thick, shiny walls (silver or copper wiring)
- AV nipping (narrowing where arteries cross veins)
- Flame haemorrhages and cotton wool spots
- Papilloedema
What is the most common secondary cause of HTN?
Primary renal disease
Name the causes of secondary HTN
- Primary renal disease
- Renovascular disease
- Cushing’s syndrome
- Primary aldosteronism
- Pheochromocytoma
- Sleep apnoea
- Obesity
- Brain tumours and encephalitis
- Coarctation of the aorta
- Hypothyroidism
- Primary hyperparathyroidism
- OCP
- NSAIDs
- Stimulants
- Calcineurin inhibitors
- Antidepressants (MAOI)
How does Polycystic Kidney disease cause HTN?
Cysts damage kidney function causing fluid retention
How does glomerular disease cause HTN?
Decreases GFR which increases BP
How does fibromuscular dysplasia cause HTN?
Narrowing of renal arteries causing reduced perfusion -> kidneys hold onto more fluid
How does Cushing’s syndrome cause HTN?
High circulating glucocorticoids
Facilitate Na+ and water retention, which increases plasma volume and BP
How does primary aldosteronism cause HTN?
Adrenal gland releases too much aldosterone
Tells kidneys to retain Na+ and water
What is pheochromocytoma?
Tumour in adrenal gland
How does sleep apnoea cause HTN?
Breathing stops and starts causing a decrease in oxygen, heart pumps harder to increase BP
How does obesity cause HTN?
Body weight increases and so volume of blood increases
How do brain tumours and encephalitis cause HTN?
Increased skull pressure decreases blood flow to parts of the brain
The body tries to increase BP to force more blood up into the skull and brain
What investigations would you do for retinopathy?
Fundoscopy
What investigations would you do for cerebrovascular disease?
Neurological exmaination
