Hypertension

Question 1

What are the factors that influence Essential Hypertension?

Answer 1

Essential Hypertension

1. Fetal factors - Low birth weight
2. Humoral factors - Autonomic nervous system, RAS
3. Genetic factors - Seen to run in families gene not yet identified
4. Environmental factors - Obese, Alcohol, Sodium and Stress
5. Insulin Resistance - association between diabetes and HTN has long been recognized

Question 2

Causes of Secondary Hypertension

Answer 2

Secondary Hypertension

1. Pregnancy (Pre-eclampsia)
2. Renal disease (Renal Artery Stenosis, Renal parenchymal disease especial glomerulonephritis, Polycystic Kidney disease)
3. Drugs (Oral contraceptives containing Estrogen, Anabolic steroids, corticosteroids, NSAIDS)
4. Coarctation of the Aorta
5. Endocrine causes (Pheochromocytoma, Cushing disease, Primary hyperaldosteronism Conns syndrome, Hyperparathyroidism, acromegaly, Primary Hypothyroidism, Thyrotoxicosis, Liddle syndrome 1b-hydroxysteroid dehydrogenase deficiency, congenital adrenal hyperplasia due to 11b-hydroxylase or 17a-hydroxylase deficiency)

Question 3

What are the complications of Hypertension?

Answer 3

Complications

1. Blood vessels
   - atherosclerosis
   - aneurysm
   - aortic dissections
2. Brain
   - Hemorrhage/Infarction
   - Seizures
   - Vascular dementia
3. Retinal damage
   - Hemorrhages
   - Exudates
   - A-V nipping
   - Papilloedema
4. Cardiac failure
   - Pulmonary Edema
   - Myocardial infarction
   - Left ventricular hypertrophy
5. Chronic Kidney disease
   - Haematuria
   - Proteinura
   - Uraemia