Pathology of HTN

Question 1

What does HTN cause ?

Answer 1

Cardiac failure

Question 2

What is HTN a risk factor for ?

Answer 2

• Cerebral haemorrhage
• Atheroma
• Renal failure
• Sudden cardiac death

Question 3

Why do renal pathologies result in HTN?

Answer 3

They cause:

1. Reduced renal blood flow
2. Resulting in excess renin release
3. Which in turn causes salt and water overload

Question 4

Define what benign HTN is

Answer 4

Essential hypertension that runs a relatively long and symptomless course. (usually incidental finding)

Question 5

What does benign HTN eventually cause ?

Answer 5

• Left ventricular hypertrophy (LVH)
• Congestive cardiac failure
• Increases atheroma - MI, Stroke
• Increases aneurysm rupture - aortic dissection, Berry aneurysms
• Renal disease

Question 6

How does benign HTN cause LVH ?

Answer 6

• It increased the LV load
• Results in poor perfusion, interstital fibrosis, micro-infarcts and diastolic dysfunction

Question 7

What can LVH caused by benign HTN inturn result in ?

Answer 7

• Sudden cardiac death - due to arrhythmia and poor perfusion
• Cardiac failure
• It also adversley affects the outcome of other diseases

Question 8

Define what malignant HTN is

Answer 8

Malignant hypertension is defined as markedly elevated blood pressure (diastolic BP often > 140 mmHg) with retinal haemorrhages, exudates or papilloedema.

Question 9

Is the management of malignant HTN an emergency ?

Answer 9

• Yes - needs urgent treatment to prevent death
• Its management should take precedence over investigations to determine whether there is an underlying cause.

Question 10

What alongside papilloedema, what can malignant HTN result in ?

Answer 10

• Acute renal failure (malignant nephrosclerosis)
• Acute heart failure
• Headache and cerebral haemorrhage
• Blood vessels show fibrinoid necrosis and endarteritis proliferans of their walls
• Death