Hypertension

Question 1

Optimal blood pressure

Answer 1

115/75 mmHg

Question 2

Threshold values of medical measurement of BP

Answer 2

> 140 or > 90

Question 3

Threshold values of at home measurement of BP

Answer 3

> 135 or > 85

Question 4

Threshold values of 24H ABPM

Answer 4

• day : > 135 or > 85
• night : > 120 or > 70
• 24H : > 130 or > 80

Question 5

What is masked HT?

Answer 5

Normal pressures in a medical office, but abnormally high during certain periods of the day

Question 6

Hypertension with known etiology

Answer 6

• monogenic, inherited

- secondary hypertension

Question 7

Hypertension with unknown origin

Answer 7

primary (essential) hypertension

Question 8

Monogenic mutation that affects kidney

Answer 8

Liddle’s syndrome : ENaC hyperfunction

Question 9

Monogenic mutations that affect steroid metabolism (3)

Answer 9

• CYP11B2 hyperfunction (AD)
• Lack of CYP11B1 (AR)
• Mineralocorticoid receptor hyperfunction (AD)

Question 10

Types of monogenic mutations not affecting kidney function

Answer 10

PDE3A mutations

Question 11

What is vascular dementia? (3)

Answer 11

• lacunar infarct ( < 20mm)
• microinfarcts ( < 1mm)
• diffuse white matter damage

Question 12

What is hypertensive crisis?

Answer 12

Sudden increase in BP causes hypertensive encephalopathy

Question 13

Major mechanisms contributing to the etiology of essential hypertension (4)

Answer 13

• Genetic inheritance, genetic predisposition
• Disorders of neuroendocrine sytems
• Salt sensitivity
• Vascular aging

Question 14

Neuroendocrine systems playing a role in the regulation of BP (5)

Answer 14

• RAAS
• Natriuretic peptides
• Endothelium
• SNS
• Immune system

Question 15

3 ways RAAS can have a role in development of essential HT?

Answer 15

• issue with renin secretion
• reduced ACE2 function
• Abnormal activation of local RAS

Question 16

What is corin?

Answer 16

An ANP converting enzyme that converts pro-BNP and pro-ANP into active forms

Question 17

Endothelium dysfunctions that contribute to etiology of HT (2)

Answer 17

• Low NO bioavailability

- High production of endothelin 1

Question 18

What is salt sensitivity ?

Answer 18

Consumption of min. 5g of salt triggers a rise of systolic BP by at least 10mmHg

Question 19

Consequences of vascular aging (4)

Answer 19

• Remodeling
• Stiffness, loss of elasticity
• Endothelial dysfunction
• Windkessel function is damaged

Question 20

When can you use non pharmacological therapies alone in HT treatment?

Answer 20

• In elevated BP

- In stage 1 HT if estimated 10 year risk of CVD is < 10%

Question 21

Drug therapy groups for HT (6)

Answer 21

• B1R blockers
• a1R blockers
• a2 antagonists
• Diuretics
• DHP calcium channel blockers
• ACE inhibitors