Cardiovascular Systems 11 - Hypertension Flashcards Preview

LSS 1 > Cardiovascular Systems 11 - Hypertension > Flashcards

Flashcards in Cardiovascular Systems 11 - Hypertension Deck (16)
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1
Q

Discuss the epidemiology of hypertension

A
  • Mean blood pressure rises with age
  • Most people over 60 are expected to be hypertensive
  • As blood pressure increases, stroke mortality increases
2
Q

Define hypertension

A

A level of blood pressure where investigation and treatment does more good than harm

3
Q

How is hypertension classified?

A
  • Secondary hypertension has an identifiable cause (eg. tumours, renal disease, contraceptive pill, genetic causes)
  • Primary/essential hypertension has an unidentifiable cause (majority)
4
Q

List the genetic and environmental causes of high blood pressure

A
  • Monogenetic/polygenetic causes (monogenetic is very rare)
  • Dietary salt
  • Obesity
  • Alcohol
  • Birth weight
  • Pregnancy
5
Q

List the monogenic diseases that cause hypertension.

A
  • Liddles syndrome (mutation in amiloride-sensitive tubular epithelial Na channel)
  • Mineralocorticoid excess (mutation in 11b-hydroxysteroid dehydrogenase)
6
Q

What is established hypertension associated with?

A
  • Increased TPR
  • Decreased arterial compliance
  • Normal cardiac output
  • Normal blood volume
  • Central shift in volume
7
Q

What causes elevated total peripheral resistance in hypertension?

A
  • Active narrowing of arteries
  • Structural narrowing of arteries (growth and remodelling)
  • Capillary loss
8
Q

What is isolated systolic hypertension?

A
  • Systolic blood pressure is over 140mmHg

- Diastolic BP is less than 90mmHg

9
Q

What causes isolated systolic hypertension?

A
  • Increasing stiffness in medium/large arteries in those over 60
  • The pulse wave is reflected and greater by the time it reaches the brachial artery
  • TPR does not increase
10
Q

What parts of the body are responsible for causes of primary hypertension?

A
  • Kidneys have a key role in BP regulation (evidence in relation to salt intake)
  • Sympathetic nervous system (high SNS hypertension)
11
Q

Describe some evidence of the kidneys being important in hypertension.

A

Rats can have a transplanted healthy kidney to remove hypertension.

12
Q

List the increased risks caused by high blood pressure?

A
  • Coronary heart disease
  • Stroke
  • Peripheral vascular disease
  • Heart failure
  • Atrial fibrillation
  • Dementia
  • Retinopathy
  • Aneurysm
13
Q

How much does hypertension increase risk of CHF?

A

2-3 fold

14
Q

How does hypertension and the eye?

A
  • The retina has microvasclar damage
  • There is thickening of the wall of small arteries, arteriolar narrowing, vasospasm, impaired perfusion and increased leakage into surrounding tissue
15
Q

What is microaluminurea?

A
  • Albumin loss in the urine
  • Caused by hypertension
  • Hypertension causes a reduced glomerular filtration rate
16
Q

List the treatments for hypertension?

A
  • Weight loss, exercise, healthy eating, reduced alcohol consumption
  • ACE inhibitors/angiotensin receptor blockers
  • Diuretics/thiazide diuretics
  • Beta blockers
  • Calcium channel blockers

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