Primary and Secondary HTN Flashcards
Primary vs Secondary HTN
Primary: idiopathic
Secondary: identifiable and treatable cause
Hypertension accelerates…
Atherosclerosis
Vascular remodelling in
- Large arteries
- Small arteries
- Arterioles
- Outward hypertrophy
- Inward hypertrophy
- Inward remodelling and rarefaction
Causes of secondary HTN
A: accuracy, sleep apnea, primary aldosteronism
B: bruits (renal artery stenosis), bad kidneys
C: catecholamines, Cushing’s, coarctation
D: diet, prescription drugs, illicit drugs
E: endocrine, erythropoietin
Renal Artery Stenosis
Narrowing of the renal arteries
Think they are getting low flow
Increase RAAS
Pheochromocytoma
Tumor of the adrenal medulla
Secretes adrenalin and noradrenalin
Leads to increased CO and vasoconstriction
What are you looking for in the fundus for signs of hypertensive retinopathy
Engorged veins
Sheen to the artery (copper or silver from hypertrophy of the muscularis)
Nicking of the vein from the artery compressing it
Hypertensive heart disease
LV hypertrophy
Risk factor for sudden death
2 biggest drivers for chronic kidney disease
HTN and diabetes
7 causes of hypertensive emergencies
Hypertensive encephalopathy Aortic dissection Myocardial infarction LH failure Intracranial hemorrhage Post-transplantation of a kidney Post-surgical
Cushing’s syndrome
Increased stimulation of the adrenal cortex by a pituitary gland adenoma
Causes elevated circulating levels of cortisol
Increases Na and water retention in the kidney
3 types of prescription drugs that increase BP
Corticosteroids
NSAIDs
Oral contraceptives with high doses of estradiol
3 types of non-prescription drugs that can increase BP
Nicotine
Herbal supplements that contain ephedra
Methamphetamines
4 main organs that can be affected by target organ damage
Eyes (retinopathy)
Brain (cerebrovascular disease)
Heart (hypertensive heart and CAD)
Kidneys (hypertensive nephrosclerosis)
Hypertensive encephalopathy
Headache, vomiting, confusion, seizures, and ultimately coma
