Hypertension General

Question 1

____% of australians over 25 have HTN?

Answer 1

30%

Question 2

does BP increase with age?

Answer 2

Yes, Systolic/pulse pressure more so

Question 3

Definition of HTN?

Answer 3

> 140/90mmHg

Question 4

What is primary HTN? what %?

Answer 4

no identifiable cause 90-95%

Question 5

what is secondary HTN? what %?

Answer 5

has a cause. 5-10%

Question 6

what is ‘benign’ HTN?

Answer 6

slow rise, doesn’t get crazy high

Question 7

what is malignant HTN?

Answer 7

rapid rise in BP

Question 8

2 forces that control BP?

Answer 8

Cardiac output: SV, HR, Volume

Arteriole resistance

Question 9

what happens to aorta in age related change?

Answer 9

decreased elastin,

increased collagen in intima

Question 10

age related change in small/medium arteries?

Answer 10

fragmented elastin,
intimal thickening due to collagen
calcification

Question 11

what commonly happens in arterioles with age related changes?

Answer 11

hyaline arteriolosclerosis (glassy)

Question 12

what is hyaline arteriolosclerosis?

Answer 12

deposition of plasma proteins in vessel walls

Question 13

does HTN have a single gene defect?

Answer 13

Nope. Very Polygenic

Question 14

HTN multifactorial such as?

Answer 14

Lifestyle

age, gender race

Question 15

who has lower blood pressure? premenopausal, age-matched males, post menopausal?

Answer 15

premenopausal

Question 16

How do you get wide pulse pressure? 2 main reasons

Answer 16

decreased compliance of aorta

increased stroke volume

Question 17

secondary HTN causes? 5 main?

Answer 17

Renal
Endocrine: from tumours over producing
vascular
medication
other: OSA, preg

Question 18

Does atherosclerosis cause hypertension?

Answer 18

In some circumstances

Question 19

main problem that essential HTN causes?

Answer 19

LV hypertrophy

Question 20

What can happen with HTN in:
large/medium arteries?
Circle of Willis?
arterioles?

Answer 20

atherosclerosis/aortic dissection
berry aneurysm
hyaline arteriolosclerosis

Question 21

main vessel defect in aneurysm is because of weakening of?

Answer 21

media

Question 22

Where is the blood in an aortic dissection?

Answer 22

in the media

Question 23

Does a reduced LV chamber size cause cardiac failure

Answer 23

Nope.

Question 24

why is the kidney sensitive to HTN?

Answer 24

unprotected glomerulus

Question 25

what can hyaline arteriolosclerosis cause chronically?

Answer 25

ischaemia/tubular necrosis

Question 26

what is a marker of severity of chronic kidney disease?

Answer 26

proteinuria

Question 27

What’s the most common cause of HTN induced kidney infarct?

Answer 27

atheroemboli: cholesterol crystal

Question 28

two things that can happen in brain with HTN? 3 things

Answer 28

infarct from hyaline arteriolosclerosis
intracerebral haemorrhage
berry aneurysm

Question 29

what happens in retina with HTN?

Answer 29

AV nipping, exudates, ischaemia, haemorrhages

Question 30

complication of malignant HTN usually arise which structures?

Answer 30

smaller arteries/arterioles

Question 31

2 vessel effects of malignant hypertension?

Answer 31

hyperplastic arteriolosclerosis

fibrinoid necrosis/thrombosis

Question 32

What can happen to brain with malignant hypertension?

Answer 32

encephalopathy

Question 33

what happens to retina with malignant hypertension?

Answer 33

retinopathy, hemorrhages, exudates