Pathology - Hypertension Flashcards
What is hypertension?
A disorder in whcih the level of sustained arterial pressure is higher than expected for the age, sex and race of the individual. Slide 3
What is hypertension a risk factor for?
Cerebral haemorrhage
Atheroma
Renal Failure
Sudden cardiac death. Slide 5
How can you classify hypertension, and therefore what are the classifications?
Can classify by cause or consequences.
Cause: Primary and secondary
Consequences: Benign and malignant.
Slide 7
What is primary hypertension?
There is no known cause.
Could be the combo of genetic factors, salt intake, their sympathetic activity. Slide 12
What is secondary hypertension?
There is an underlying disease.
E.g. renal disease, endocrine, aortic, renal artery stenosis and drug therapy.
What renal diseases can cause secondary hypertension and how?
Renal artery stenosis Acute or chronic glomerulonephritis Chronic pyelonephritis Cystic diseases Interstitial nephritis.
They cause reduced renal blood flow which causes excess renin release and that increases water retention. Slide 15
What are endocrine causes of hypertension?
Adrenal gland hyperfuntion due to tumours
e.g. Conn’s syndrome - excess aldosterone
Cushing’s syndrome - excess corticosteroid
Phaeochromocytoma - excess noradrenaline.
Slide 16
What is the aortic disease that can cause hypertension?
Coarction of the aorta.
Slide 17
Is benign hypertension safe and why?
It is not safe as it slowly progresses and becomes very dangerous.
It can cause LV hypertrophy, increases atherome, renal disease. Slide 19
What can hypertension do to the heart?
Increase LV load LV hypertophy Poor myocardial perfusion Interstitial fibrosis Diastolic dysfunction Cardiac Failure. Slide 20
Can aortic dissection occur due to hypertension?
Yes. Slide 26
What diseases can hypertension cause?
Hypertensive heart disease Left Ventricular failure Complicated atheroma Aortic dissecting aneurysm Stroke Subarachnoid haemorrhage Slide 23-28
What causes microvascular injury in kidneys and in eyes and what specifically are these injuries?
Hypertension
Blood vessel wall changes
Thickening of media
Hyaline arteriosclerosis.
Slide 30
When is hypertension malignant?
When diastolic is >130-140
Slide 32
Name some complications of malignant hypertension?
Cerebral oedema (papilloedema) Acute renal failure Acute heart failure Headache and cerebral haemorrhage Slide 33
