Lec 1 Hypertension Flashcards
What is hypertension defined as?
A systolic BP of 130 mm Hg or more or a diastolic BP of 80 mm Hg or more, taking antihypertensive medication, or having been told by clinicians on at least two occasions as having hypertension.
What occurs in accelerated or malignant-phase hypertension?
Arteriolar fibrinoid necrosis occurs.
What is often associated with fibrin deposition within small vessels?
Thrombocytopenia and red-cell fragmentation seen in the peripheral blood film (microangiopathic haemolytic anaemia).
What is a characteristic change in benign essential hypertension?
Arteriosclerosis of major renal arteries and changes in the intrarenal vasculature (nephrosclerosis).
What happens to the size of the kidneys in benign essential hypertension?
Reduction in size of both kidneys may occur; this may be asymmetrical.
What leads to reduced renal perfusion in hypertension?
Changes in the renal vasculature.
What is a significant prognostic indicator of future cardiovascular events in hypertension?
Left ventricular hypertrophy.
In chronic hypertension, what maintains the elevated blood pressure?
Increased peripheral resistance.
What structural changes occur in resistance vessels in hypertension?
Increase in wall thickness and reduction in vessel lumen diameter.
What is true about cardiac output in some young hypertensive patients?
There is an increase in cardiac output, in association with increased pulse rate and circulating catecholamines.
What is secondary hypertension?
Blood pressure elevation due to a specific and potentially treatable cause.
What routine tests are performed for hypertension?
- ECG
- Urinalysis
- Blood glucose level
- Serum potassium
- Creatinine
- Lipid profile
- Measurement of urinary albumin excretion or albumin/creatinine ratio.
What is hypertension classified into?
Essential or secondary.
What are the major causes of premature vascular disease associated with hypertension?
- Cerebrovascular events
- Ischaemic heart disease
- Peripheral vascular disease.
What types of medications are used in the treatment of hypertension?
- ACE Inhibitors
- RRB
- Beta Blockers
- Calcium Channel Blockers
- Diuretics.
What does grade 1 fundoscopy indicate?
Tortuosity of the retinal arteries.
What is endothelin?
A potent vasoactive peptide produced by endothelial cells with both vasoconstrictor and vasodilator properties.
What is the relationship between sodium intake and blood pressure?
A high sodium intake is suggested to be a major determinant of blood pressure differences.
What fetal factor is associated with subsequent high blood pressure?
Low birth weight.
How does age affect blood pressure?
Blood pressure tends to rise with age due to arterial stiffening and reduced vascular elasticity.
What role does obesity play in hypertension?
It activates the renin-angiotensin system in adipose tissue.
What effect does stress have on blood pressure?
Increases sympathetic outflow and may lead to vascular hypertrophy.
What determines cardiac output?
Stroke volume and heart rate.
What is the primary active pump for solute transport across the cell membrane?
The sodium-potassium pump.
What is the composition of extracellular fluid (ECF)?
- Interstitial fluid
- Blood plasma.
What does Starling’s law describe?
The volume of interstitial fluid is determined by the difference between hydrostatic pressure and oncotic pressure.
What are the three major fluid compartments in the body?
- Intracellular fluid
- Interstitial fluid
- Plasma.
What are the two major subcompartments of extracellular fluid?
- Interstitial fluid
- Blood plasma.
What is the effect of endothelial dysfunction in hypertension?
It leads to changes in vascular tone, reactivity, and coagulation pathways.
What is the formula for blood pressure maintenance?
Blood Pressure = Cardiac Output x Peripheral Resistance.
What is the impact of genetic factors on hypertension?
Family history and genetic variations affect blood pressure regulation.
What is the primary interstitial solute?
Na
What is the primary plasma solute?
protein
Where is the majority of blood volume located at rest?
within the venous system
What is a major determinant of cardiac output?
Venous return to the heart
What happens with diminished venous return to the heart?
Decreased cardiac output
What type of receptor is stimulated by baroreceptors during decreased cardiac output?
β1-adrenergic receptors
What is the result of stimulation of sympathetic fibers?
Increased heart rate and contractility
What effect does increased workload have on myocardial O2 consumption?
Increases myocardial O2 consumption
What must be maintained to prevent myocardial dysfunction?
Myocardial O2 supply
What are the determinants of tissue perfusion?
Distribution of COP
Fill in the blank: Venous return to the heart is a major determinant of _______.
cardiac output
True or False: Increased workload decreases myocardial O2 consumption.
False
What does increased cardiac output lead to?
Increased myocardial O2 consumption
What physiological response occurs due to decreased cardiac output?
Increased heart rate and contractility
What must be adequate for proper tissue perfusion?
Adequate Tissue Perfusion
