Hypertension - aetiology and pathophysiology

Question 1

Define hypertension

Answer 1

Blood pressure above which the benefits of treatment outweigh the risks in terms of morbidity and mortality

Question 2

Define morbidity

Answer 2

incidence of ill health in a population

Question 3

Define mortality

Answer 3

number of people who died within a population

Question 4

State the NICE guidelines for stage 1, stage 2 and severe hypertension

Answer 4

stage 1 - 140/90mmHg / ABPM 135/85mmHg

stage 2 - 160/100mmHg / ABPM 150/95mmHg

Severe - 180/110mmHg

Question 5

Name some causes of hypertension

Answer 5

Chronic renal disease
Secondary hypertension
Renal artery stenosis
Endocrine disease e.g. Conns syndrome

Question 6

What is cigarette smoking said to do to your blood pressure?

Answer 6

Adds 20/10mmHg

Question 7

What is diabetes said to do to your blood pressure?

Answer 7

5-30 X increase in blood pressure

Question 8

Name some risk factors for high blood pressure

Answer 8

Smoking
DM
Renal disease
Male
Hyperlipidaemia
Previous MI or stroke
Left ventricular hypertrophy

Question 9

What 3 factors stimulate the RAAS system?

Answer 9

Fall in BP
Fall in circulating volume
Sodium depletion

Question 10

Name two likely causes of hypertension

Answer 10

Increased reactivity of resistance vessels

Sodium homeostatic defect

Question 11

Why is BP thought to increase with age?

Answer 11

Decreased arterial compliance

Question 12

How many genes are linked to hypertension, and how much are they thought to contribute?

Answer 12

> 30 genes

Individually account for 0.5mmHg each

Question 13

What levels of salt should people with hypertension be consuming a day?

Answer 13

<6g/day

Question 14

Name 4 renal disease which can cause secondary hypertension

Answer 14

Chronic pyelonephritis
Fibromuscular dysplasia
Renal artery stenosis
Polycystic kidneys

Question 15

Name some drugs that can cause secondary hypertension

Answer 15

NSAIDs
Oral contraceptive
Corticosteroids

Question 16

Name some endocrine disorders which can cause secondary hypertension

Answer 16

Conns syndrome
Cushings syndrome
Phaeochromocytoma
Thyroid issues
Acromegaly