Week 3 (3) Systemic Hypertension

Question 1

Why is Hypertension a problem?

Answer 1

It DOUBLES the risk of cardiovascular diseases including:

• IHD
• Congestive Heart Failure
• Stroke
• Renal failure

Question 2

What is normal BP?

Answer 2

120/80

Question 3

Blood Pressure

Answer 3

BP results from 2 foces

• The heart as it pumps bloos (heart rate, stroke volume)

AND

• resistance in arterioles

BP = cardiac output x peropheral resistance

Question 4

Receptors detect blood pressure and flow in the?

Answer 4

• kidneys
• major arteries
• the heart

Question 5

Age related arterial changes

Answer 5

Aorta - loss of elasticity

*fragmentation of elastin

*increased collagen

Small and medium arteries - fragmentation of elastin, increased collagen, sometimes calcification

arterioles - hyaline atherosclorosis - deposition of plasma proteins in wall, increased collagen, smooth muscle atrophy, arteriole wall becoems thickened by homogeouns eosionphilic glassy material (“hyaline”) and the lumen is narrowed!

Question 6

Two different types of HYPERTENSION

What are they?

Answer 6

Primary - no specific identifiable cause (95% of cases)

-benign or malignant

Secondary (identifiable cause)

• benign or malignant

Question 7

What are the SECONDARY causes of HT?

Answer 7

• some renal diseases (diabetic renal disease, chronic renal failure)
• some endocrine diseases (tumours of adrenal gland producing aldosterone or adrenaline)
• some drugs (corticosteroids)
• sleep apnoea

Question 8

What else can influence HT

Answer 8

Genetic Factors

• renal sodium excretion
• arteriolar tone

Lifestyle Factors

-salt content, obesity

amount of exercise

metabolic syndromw

alcohol intake

Question 9

What is metabolic syndrome?

Answer 9

People will have metabolic syndrome if they have the majoority of the following:

• obesity
• insulin resistance
• low HDL Cholesterol
• high triglyerides
• hypertension

Question 10

The direct effects of hypertension?

Answer 10

= left ventricular hypertrophy

= BIG WALL OF LEFT SIDE OF HEART

Question 11

Hyaline Formation

Answer 11

Hyaline artheriolosclerosis refers to thickening of the walls of arterioles by the deposition of hyaline material.

Associated with aging, hypertension, diabetes

Question 12

Hyaline arteriolosclerosis in ARTERIOLES

Answer 12

• deposition of plasma proteins in the wall
• increased collagen
• smooth muscle atrophy
• arteriole wall becomes thickened by homogenous eosinophilic glassy material (hyaline) and the lumen is narrowed.

Question 13

Hypertension can also cause damage to…

Answer 13

THE RETINA

Can end up with bleeding, fatty deposits and microstrokes.

Question 14

What are the LONG term complications of HT?

Answer 14

There is an increased risk of

• atherosclerosis
• heart failure due to LVH +/- IHD
• hyaline arteriolosclerosis –> chronic ischaemic atrophy of nephrons, visual deterioration due to ischaemia and leaky vessels in retina, intracerebral haemorrhage due to risk of microaneurysm formation and rupture