Hypertension Flashcards
What pathology does HT predispose in the medium arteries?
Berry aneurysms
What should you do when HT is diagnosed in a patient?
Look for a secondary cause
Assess risk factors
Look for organ damage
Formulate a treatment plan
T/F Atherosclerosis doesn’t cause hypertension
False, there is one circumstance when it can
- when renal arterioles are affected > hypofusion of kidneys > activation of RAAS > HT
Why does the aorta harden with age?
Fragmentation of elastin and increased deposition of collagen in the media
Increased collagen in the intima
Which proteins get deposited in hyaline arteriolosclerosis?
Albumin and fibrin predominantly
Which pathological process is responsible for most coronary artery occlusions in MIs? (eg is it emboli)
Atherosclerosis with thrombosis
What is the pathogenesis of microangiopathic hemolytic anemia
RBCs are physically damaged by fibrin mesh (from clotting) in small vessels
How can malignant HT cause encephalopathy?
Failure of autoregulation of blood supply to the brain > Hyperperfusion > Cerebral oedema
How does having HT affect the development of hyaline arteriolosclerosis?
Increases its development
T/F Resistance in large arteries has the greatest affect on BP
False, resistance of arterioles does
What percentage of hypertension is primary?
90-95%
What are some secondary causes of hypertension?
Renal - eg diabetic glomerulosclerosis
Endocrine - eg adrenocortical adenoma producing cortisol
Vascular - eg coartation of the aorta
Medications
What are the BP cut offs for hypertension?
>140mmHg systolic
>90mmHg diastolic
What percentage of Australians are predicted have hypertension or are being treated for hypertension?
30%
What are three complications of aortic dissection?
Haemoperidium (blood flows back towards the heart and into the pericardium)
Rupture of wall
Extension of dissection leading to compression of a branch
Is reduction in lumen size a factor in the cause of heart failure due to concentric hypertrophy?
No
- Impairing diastolic filling
- Increasing the myocardial oxygen demand
- Reducing the coronary perfusion pressure gradient
Are more important
What pathology does HT predispose in the arterioles?
Hyaline arteriolosclerosis
What is the difference between benign and malignant hypertension?
Benign isn’t v. high and develops slowly
Malignant is v. high and can develop quickly
Name some of the factors that contribute to the development of primary hypertension
Genetics eg sympathetic responses
Lifestyle eg obesity
Age
Gender
Race eg higher in black people
What effect does hyaline arteriolosclerosis have on BP?
Slight increase
What is the effect of age related hardening of the aorta on BP?
Causes increased BP
In which layer of artery walls does blood sit in aortic dissection?
The medium - it’s the only layer strong enough
What are two causes of stroke?
Embolism
Haemorrhage
What is the difference between primary and secondary hypertension?
Secondary has an identifible cause whereas primary does not
