Hypertension (Kostis) - 11/8/16

Question 1

Hypertension defined.

Answer 1

Systolic BP > 140 mm Hg

and/or

Diastolic BP > 90 mm Hg

Question 2

Risk factors (8)

Answer 2

• Inc. age
• Obesity
• Diabetes
• Physical inactivity
• Excess salt intake
• Excess alcohol intake
• Family hx
• African American > Caucasian > Asian

Question 3

Classification of Hypertension

Answer 3

1. Essential HTN (90-95%)
   
   1. Related to inc. CO or inc. TPR
2. Secondary HTN (5-10%)
   
   1. Mostly secondary to renal/renovascular disease (RAS)
      
      1. Fibromuscular dysplasia (non-atherosclerotic, non-inflammatory disease that causes abnormal growth in artery walls)
         
         1. Usually found in younger women
         2. “String of beads” appearance
         3. Commonly affects renal arteries
   2. Primary hyperaldosteronism
   3. Thyroid Disease
   4. Cushing Syndrome
   5. Aortic Coarctation

Question 4

Hypertensive urgency

vs

Hypertensive emergency

Answer 4

Hypertensive urgency – severe (>180/>120 mm Hg) HTN without acute end-organ damage

Hypertensive emergency – severe HTN w/ evidence of acute end-organ damage (e.g. encephalopathy, retinal hemorrhages, stroke, papilledema, MI, HF, aortic dissection, kidney injury, eclampsia)

Question 5

HTN predisposes to:

Answer 5

Heart:

• CAD
• LVH
• HF
• AF
• Aortic dissection
• Aortic aneurysm

Stroke

Chronic Kidney Disease (hypertensive nephropathy)

Retinopathy