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Flashcards in lecture 10: hypertension Deck (21)
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1
Q

what is hypertension?

A

the level of blood pressure above which investigation and treatment will do more good than harm

2
Q

how many people does hypertension affect?

A

1 billion people and it is the highest global cause of death

3
Q

what is pre hypertension?

A

just before people get hypertension

4
Q

how does blood pressure change with age?

A
  • the mean Blood pressure increases with age
  • pulse pressure rises with age
  • therefore majority of 60 + care hypertensive
  • almost all 80+ are hypertensive
5
Q

is there a threshold for the risk of a stroke?

A
  • there is no threshold for risk of stroke
  • for every 20mmHg increase in BP doubles risk of the stroke
  • as there is no threshold it means that a large burden of the disease is on people with a high blood pressure
6
Q

what is primary hypertension?

what is secondary hypertension?

A
  • primary = hypertension from an unidentifiable cause (95%)

- secondary = hypertension from a disease of which hypertension is a symptom
5%

7
Q

what are the two types of genetic causes of hypertension?

A
  • monogenic

- complex polygenic

8
Q

what are the monogenic causes?

how common?

A
  • liddles syndrome

- Apparent mineralocorticoid excess

9
Q

what are the complex polygenic causes?

how common?

A

basically multiple genes causing hypertension

10
Q

what are some environmental causers of hypertension?

A
  • dietary salt - principle cause
  • obesity
  • alcohol
  • pregnancy
  • pre natal environment
11
Q

what things is hypertension associated with?

A
  • increased TPR
  • reduced arterial compliance
  • normal CO and normal blood volume
12
Q

what is isolated systolic hypertension?

A
  • it is due to stiffer large arteries

- stiffer arteries reflect the pulse wave and amplify it instead of cushioning it

13
Q

what are reasons for increased TPR?

A
  • active narrowing of the arteries (vasoconstriction)
  • structural narrowing of the arteries (growth and remodelling)
  • loss of capillaries
14
Q

what are some causes of hypertension?

A
  • the kidneys
    play a role in salt regulation and therefore BP regulation
  • sympathetic nervous system
  • some evidence
15
Q

what are some results of hypertension?

A
  • Coronary heart disease
  • stroke
  • heart failure
  • atrial fibrillation
  • dementia
  • retinopathy
16
Q

how does hypertension affect the heart?

A
  • causes hypertrophy
    (increase the muscle size)
  • remodelling (change of ventricular volumes)
17
Q

how does hypertension affect the large arteries?

A
  • accelerates atherosclerosis and aneurysms
18
Q

how does hypertension affect the retina?

A
  • affects the microcirculation of the retina
  • thickening of the small arteries
  • means the arteries narrow
  • vasospasm (spasming that results in vasoconstriction)
  • this means less passage of blood happens
  • more plasma leak happens
19
Q

how does hypertension affect microvasculature?

A
  • less capillary density

- elevated capillary pressure

20
Q

how does hypertension affect kidneys?

A

Increased albumin secretion in urine

21
Q

possible treatment for hypertension?

A
  • lifestyle changes
  • ACE inhibitors and angiotensin receptor blockers
  • diuretics