Hypertension Flashcards
List 2 causes of monogenic hypertension
Liddle’s syndrome
Apparent mineralocorticoid excess
Established hypertension is associated with
Increased total peripheral resistance
reduced atrial compliance (higher pulse pressure)
Normal CO
Normal blood volume/extracellular volume
Central shift in blood volume (secondary to reduced venous compliance)
How do you calculate CO
CO = MABP / TPR
3 causes of TPR
Active narrowing of the arteries (vasoconstriction)
Structural narrowing of the arteries (growth and remodelling)
Loss of capillaries
What is isolated systolic hypertension?
140/90
What are the risk groups of isolated systolic hypertension ?
> 60yo
What causes isolated systolic hypertension ?
Increasing stiffness of medium/large arteries
Pulse wave reflected and is greater by the time it reaches the brachial artery (insted of being dampen down by the vessels it is being amplified)
List 3 candidate causes of primary hypertensions
Kidney Sympathetic NS (high sympathetic activity --> development of hypertension) Endocrine/paracrine factors
How does the kidney influence blood pressure?
Regulation of sodium/water/extracellular fluid volume
How does hypertension affect the structure of the heart?
Increase in left ventricular wall mass (LVMI)
Changes in chamber size
By how much does hypertension increase the risk of heart failure?
x2-3
What is hypertension commonly associated with? (2)
Thickened walls (hypertrophy) of large arteries Acceleration of atherosclerosis
What might hypertension cause? (2)
Arterial rupture or aneurysms
What can arterial rupture and aneurysms lead to
Thrombosis
Haemorrhage
How does hypertension affect the retina?
Microvascular damage Thickening of the wall of small arteries Arterial narrowing Vasospasm Impaired perfusion Increased leakage into the surrounding tissue
