Hypertension

Question 1

What two conditions are directly increased in risk, with hypertension?

Answer 1

Stroke

Coronary Heart Disease

Question 2

How is Blood Pressure distributed - Bimodally, or Normally?

Answer 2

Normal distribution

Question 3

State 4 things which maintain blood pressure

Answer 3

• RAAS
• Poiseulle’s Law
• Baroreceptors
• Renal function

Question 4

What % of patients have Primary Hypertension? What is the cause of Primary Hypertension?

Answer 4

90 - 95% of patients

No known cause

Question 5

What is the equation for Arterial Blood Pressure (ABP)

Answer 5

ABP = CO x R

CO = Cardiac Output
R = Peripheral Vascular Resistance

Question 6

In the Early stages of Primary Hypertension, what is the level of Blood volume and Cardiac Output?

Answer 6

Blood volume = high

Cardiac output = high

Question 7

In the Chronic stages of Primary Hypertension, what is the level of Blood volume and Cardiac Output?

Answer 7

Blood volume = normal
Cardiac output = normal
Systemic vascular resistance = high

Question 8

What changes to the kidney might Hypertension cause?

Answer 8

Thickening of the glomerulus, hyaline changes

Question 9

In hypertension, what difference is there in the function of the endothelial and smooth muscle cells?

Answer 9

In hypertensive patients, the endothelium produces less NO (less vasodilation)

Question 10

Secondary hypertension accounts for what hypertensive patients?

Answer 10

5-10%

Question 11

Outline the pathophysiology of Renal Artery Stenosis

Answer 11

Renal stenosis causes reduced afferent arteriole pressure.

This renin leads to increased angiotensin II and aldosterone secretion.

This promotes increased cardiac / vascular hypertrophy, increased blood volume, CO and vascular resistance.

Question 12

Where is Aldosterone produced?

Answer 12

In the adrenal glands (zona glomerulosa)

Question 13

What is Conn’s syndrome known as? What is its pathophysiology

Answer 13

Also known as Primary Aldosteronism, where there is an adrenal tumour / hyperplasia leading to increased Aldosterone production. This leads to increased Na+ and water retention

Question 14

In patients with Primary Aldosteroneism (Conn’s), they are retaining Na+ and Water in favour of loss of which ion?

Answer 14

K+ excretion (patients are hypokalaemic)

Question 15

What is the pathophysiology of Phaechromocytoma

Answer 15

Adrenal medullary tumours secreting catecholamines. Causes alpha-mediated vasoconstriction and beta-mediated cardiac stimulation

Question 16

A patient comes in with upper body hypertension, and lower body normotention. What condition might this be?

Answer 16

Coarctation of the Aorta

Question 17

Hypertension has what effect on tissue of the heart?

Answer 17

Left ventricular hypertrophy (doesn’t affect right side as much)