Hypertension

Question 1

Maintenance of a normal blood pressure is dependent on the balance between the ———- and —————

Answer 1

cardiac output and peripheral vascular resistance.

Question 2

.
• Most patients with essential hypertension have a normal ———- but a raised ————

Answer 2

Most patients with essential hypertension have a normal cardiac output but a raised peripheral resistance

Question 3

many interrelated factors contribute to the raised blood pressure in hypertensive patients.
Among the factors that have been intensively studied are

Answer 3

salt intake,
obesity,
insulin resistance,
The renin- angiotensin system, and t
The sympathetic nervous system.

Question 4

HT affects up to —% of the population of the world
• It is responsible for many cases of ——, ——- and ———disease

Answer 4

20%

• It is responsible for many cases of MI, stroke and chronic renal disease

Question 5

• • •
PREVALANCE
— to —% in unacculturated societies Yanomami Indians, Papua New Guinea
and —— people in Nigeria
—% in Black Americans.
Male > Female below —yrs
Female>Male after — yr

Answer 5

• • •
PREVALANCE
Varied worldwide
0-2% in unacculturated societies Yanomami Indians, Papua New Guinea
and koma people in Nigeria
40% in Black Americans.
Male > Female below 50yrs Female>Male after 50 yr

Question 6

MALIGNANT HT
• A rapidly increasing BP over a period of ————-
• The BP is usually very high and rapidly increasing (eg diastolic >——mmHg)
• The clinical effects are serious, damaging many organs
• This is common in ———-

Answer 6

MALIGNANT HT
• A rapidly increasing BP over a period of few months or 1 or 2 years
• The BP is usually very high and rapidly increasing (eg diastolic >120mmHg)
• The clinical effects are serious, damaging many organs
• This is common in young HTensives

Question 7

Aetiological classification

Answer 7

Benign
Malignant
Essential
Secondary

Question 8

EFFECT OF ORAL CONTRACEPTIVES ON BP
• Acts by activating the ——— pathway

Answer 8

• Acts by activating the RA pathway

Question 9

Causes of Secondary Hypertension
A. Renal
B. Endocrine

Answer 9

Causes of Secondary Hypertension
Renal
-Acute glomerulonephritis
-Chronic renal disease
-Polycystic disease
-Renal artery stenosis
-Renal artery fibromuscular dysplasia
-Renal vasculitis
-Renin-producing tumors

Endocrine  -Adrenocortical hyperfunction (Cushing syndrome, primary aldosteronism, congenital adrenal hyperplasia)  -Exogenous hormones (glucocorticoids, estrogen [including pregnancy-induced and oral contraceptives], sympathomimetics  -Pheochromocytoma  -Acromegaly  -Hypothyroidism (myxedema)  -Hyperthyroidism (thyrotoxicosis)  -Pregnancy-induced

Question 10

Causes of Secondary Hypertension ctd
C.Cardiovascular
D. Neurologic

Answer 10

Causes of Secondary Hypertension ctd
Cardiovascular
-Coarctation of aorta
-Polyarteritis nodosa (or other vasculitis)
-Increased intravascular volume
-Increased cardiac output
-Rigidity of the aorta
Neurologic
-Psychogenic
-Increased intracranial pressure
-Sleep apnea
-Acute stress, including surgery