Hypertension General Flashcards
____% of australians over 25 have HTN?
30%
does BP increase with age?
Yes, Systolic/pulse pressure more so
Definition of HTN?
> 140/90mmHg
What is primary HTN? what %?
no identifiable cause 90-95%
what is secondary HTN? what %?
has a cause. 5-10%
what is ‘benign’ HTN?
slow rise, doesn’t get crazy high
what is malignant HTN?
rapid rise in BP
2 forces that control BP?
Cardiac output: SV, HR, Volume
Arteriole resistance
what happens to aorta in age related change?
decreased elastin,
increased collagen in intima
age related change in small/medium arteries?
fragmented elastin,
intimal thickening due to collagen
calcification
what commonly happens in arterioles with age related changes?
hyaline arteriolosclerosis (glassy)
what is hyaline arteriolosclerosis?
deposition of plasma proteins in vessel walls
does HTN have a single gene defect?
Nope. Very Polygenic
HTN multifactorial such as?
Lifestyle
age, gender race
who has lower blood pressure? premenopausal, age-matched males, post menopausal?
premenopausal
How do you get wide pulse pressure? 2 main reasons
decreased compliance of aorta
increased stroke volume
secondary HTN causes? 5 main?
Renal Endocrine: from tumours over producing vascular medication other: OSA, preg
Does atherosclerosis cause hypertension?
In some circumstances
main problem that essential HTN causes?
LV hypertrophy
What can happen with HTN in:
large/medium arteries?
Circle of Willis?
arterioles?
atherosclerosis/aortic dissection
berry aneurysm
hyaline arteriolosclerosis
main vessel defect in aneurysm is because of weakening of?
media
Where is the blood in an aortic dissection?
in the media
Does a reduced LV chamber size cause cardiac failure
Nope.
why is the kidney sensitive to HTN?
unprotected glomerulus
what can hyaline arteriolosclerosis cause chronically?
ischaemia/tubular necrosis
what is a marker of severity of chronic kidney disease?
proteinuria
What’s the most common cause of HTN induced kidney infarct?
atheroemboli: cholesterol crystal
two things that can happen in brain with HTN? 3 things
infarct from hyaline arteriolosclerosis
intracerebral haemorrhage
berry aneurysm
what happens in retina with HTN?
AV nipping, exudates, ischaemia, haemorrhages
complication of malignant HTN usually arise which structures?
smaller arteries/arterioles
2 vessel effects of malignant hypertension?
hyperplastic arteriolosclerosis
fibrinoid necrosis/thrombosis
What can happen to brain with malignant hypertension?
encephalopathy
what happens to retina with malignant hypertension?
retinopathy, hemorrhages, exudates
