Hypertension

Question 1

differentiate elevated BP, stage 1 HTN, and stage 2

Answer 1

elevated= 120-129/<80
stage 1=130-139 or diastolic 80-89
stage 2= >140 or diastolic >90

Question 2

systolic BP w/ aging

Answer 2

increases!

Question 3

other compounding risk factors (w/ HTN) for CVD

Answer 3

LDL/HDL, DM, smoking, LVH

Question 4

describe causes of HTN as aging progresses

Answer 4

at a young age, mostly from high CO

older is more from high peripheral resistance

Question 5

organs most at risk from HTN

Answer 5

heart, arteries, brain, kidney

Question 6

3 CV structures affected by HTN

Answer 6

heart, large and medium arteries, microvasculature

Question 7

major effect of HTN on heart

Answer 7

LVH- higher afterload and work done causes hypertrophy and increased stiffness

Question 8

LVH morpho

Answer 8

concentric growth into lumen of LV, enlarged cardiac myocytes w/ larger nuclei

Question 9

LVH on EKG

Answer 9

greater positive voltage in left leads (I, aVL, V5 and V6) and negative in right leads (V1, V2, V3)

Question 10

most common Dx with EKG for LVH

Answer 10

add S wave in V1 and R in V5 or 6= 35mm

Question 11

extra abnormalities on EKG from LVH

Answer 11

ST depressions and T inversions in lateral leads (I, aVL, V5 and 6)

dont indicate occlusion, secondary to LVH

Question 12

HTN effect on large-medium arteries

Answer 12

accelerated atherosclerosis and its sequelae

Question 13

Chronic HTN effects on microvasculature

Answer 13

thickened vessel wall and stenotic lumen- amorphous pink hyaline expansion

Question 14

chronic HTN effect on small arteries

Answer 14

adapt w/ more elastin and collagen- benign arteriosclerosis

Question 15

chronic HTN effect on arterioles

Answer 15

adapt and sometimes injury with more collagen and plasma proteins- benign arteriolosclerosis

Question 16

other cases w/ same microvascular lesions as chronic HTN

Answer 16

DM and aging

Question 17

renal complications of chronic HTN

Answer 17

stenotic lumen in renal microvasculature causes ischemia and renal failure - benign nephrosclerosis

Question 18

optical complications of chronic HTN

Answer 18

not usually damaging vision, but can view affected vessels in situ

Question 19

severe, acute HTN effects on microvasculature

Answer 19

thickened wall/stenotic lumen w/ more layers of SMC (like an onion) and fibrinoid necrosis from endothelial injury- (looks like pink fibrin, thrombogenic)

malignant arteriosclerosis and arterolosclerosis

Question 20

3 main factors contributing to high BP

Answer 20

high CO, high SVR, vascular stiffness