Hypertension Flashcards
Stages of hypertension
Pre HTN = 120-139/80-90
Stage 1 = 140-160/90-100
Stage 2 = 160+/100+
What causes systolic BP to increase?
Stroke Volume - preload, contractility, after load
Aorta compliance - vessel elasticity – age
XS sodium – >increased plasma volume – > increased SV –> increased SBP
What causes diastolic blood pressure to increase
Volume of blood in aorta @ diastole
Vaso Visco Heart rate
Vasoconstriction of arterioles = increased TPR ->
⬇️ blood @ arterioles –> ⬆️blood @ aorta
⬆️viscosity
⬆️HR -> ⬇️️filling of CA -> ⬆️️vol @ aorta @ diastole
Explain essential primary hypertension.
High or low renin?
Genetic (black >white), salt obesity smoking stress NO exercise –>
⬇️ renal sodium excretion – >⬆️ plasma vol -> ⬆️SV -> ⬆️SBP
PVR arteriole constriction -> ⬆️DBP
LOW RENIN HTN
Explain secondary hypertension.
High or low renin?
Fibromuscular dysplasia – young female
Atherosclerosis - old male –>
Renal artery stenosis = epigastric bruit ->
⬇️BF to glomerulus -> JG app make renin -> ⬆️AT2
DCT Na resorption -> water follow -> ⬆️SBP
Treatment of hypertension
ACE inhibitors , Beta-blockers, diuretics
PCI angioplasty
Explain benign hypertension
Clinically silent – damage vessels and organs over time
Explain malignant hypertension
> 200/120
Pre-existing benign HTN/de novo –> malignant HTN
->
ACUTE END-ORGAN FAIL = Fibrinoid necrosis
Headache
Papilloedema
Renal fail
Pathologic Causes of hypertension
InterCranial HTN –
intraCCerebral – CCharcot bouchard aneurysm
suBBarachnoid - BBerry aneurysm
HYPERtensive retinopathy
Papilloedema, retinal vessel hemorrhage
Hyper+Hypo PTism + Graves
Adult coarctation
Cushings conns pheochromocytoma
PKD, Renal Art Sten, glomerulonephritis, aldosteronism
What percentage of adults have hypertension?
Types? Percentages?
25–30% of adults
Primary essential hypertension = 85%
Secondary hypertension = 15%
