Systemic Hypertension Flashcards

1
Q

Systemic Hypertension

Define

A

Persistent elevation of systolic and diastolic pressures in the systemic arteries.

Clinic: 140/90 rises slightly with age

Signs: Asymptomatic/ headache, dizziness, nosebleed/ target organ failure.

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2
Q

Aetiology

Primary

A

Idiopathic HPT usually familial & >40yrs

Hypothesis: high sodium in genetically predisposed individuals.

Genetic: RAA system, sympathetic nervous system & sodium homeostasis

Environmental: smoking, high sodium, high serum lipids, obesity, stress

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3
Q

Aetiology
Secondary
Causes

A
Renal
Placental
Hormonal
Aortic Coartation
Neurogenic
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4
Q

Secondary Hypertension

Renal pathophysiology

A

Lesions cause renal hypoperfusion -> activating release of Renin

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5
Q

Secondary Hypertension

Placental pathophysiology

A

Placental hypoperfusion

Immune related

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6
Q

Secondary Hypertension

Hormonal

A

Conn’s Syndrome
(hyperplasia/ adenoma of glomerulosa layer of the adrenal cortex producing aldosterone) -> increase serum sodium/ decreased protons

Cushing’s syndrome
(Bilateral adrenocortical hyperplasia) -> release cortisol secondary to excess ACTH

Congenital adrenal hyperplasia (Adrenogenital syndrome)

Acromegaly due to GH

Hyperthyroidism (Grave’s disease)

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7
Q

Secondary Hypertension

Aortic coarctation

A

Pre-stenotic Raised systolic BP -> non-pulsatile flow to the kidney ->Renal HPT

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8
Q

Secondary Hypertension

Neurogenic

A

Raised intracranial pressure -> reduced cranial blood flow-> psychogenic causes or polyneuritis

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9
Q

Complications

Heart

A

LV Hypertrophy-> LV dilation-> LV failure

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10
Q

Complications

Arteries

A

Benign HPT-> hyaline arteriolosclerosis in systemic arterioles-> intimal fibrosis, medial hypertrophy & hyalinization

Malignant HPT-> lesions in arterial intima & fibrinoid necrosis of the wall

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11
Q

Complications

Kidneys

A

Hypertensive nephrosclerosis -> chronic renal failure

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12
Q

Complications

Brain

A

Cerebral artery spasm-> Hypertensive encephalopathy

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