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19 Cards in this Set
- Front
- Back
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What is hypertension?
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A SYNDROME encompassing a large group of disorders in which the SAP is regulated at a sustained abnormally elevated level
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What are the 2 broad groups of hypertension?
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1. Primary (essential) hypertension
2. Secondary hypertension |
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What are the detrimental consequences of hypertension in the LV, arterial system, and the kidney?
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LV: Higher systolic pressure --> LV wall stress --> LVH and fibrosis of myocardium (impaired diastolic relaxation)
Arterial System: Must contain increased Pressure. Increased wall stress, aneurysms, acceleration of atherosclerosis Kidney: Destruction of kidney due to arteriolar destruction |
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Hypertension is associated with an increased frequency in what?
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Virtually all disorders caused by disease of the arterial system (ex: MI, stroke, CHF)
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Does hypertension increase with age?
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In western societies yes.
In primitive societies no. |
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Intake of what ion is very detrimental to cardiovascular health and helps cause hypertension?
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Salt (sodium)
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What are the causes of primary and secondary hypertension?
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Primary: No identifiable cause. 94% of cases.
Secondary: Caused by a disorder of one of the arterial pressure regulatory mechanisms (Ie Kidney disease, adrenal disease, CNS disease, drug intake) |
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What are 3 mechanisms which should prevent the development of hypertension?
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1. Baroreceptor reflex - stretch receptors which should signal to decrease pressure
2. Pressure-Naturiuresis - slow mechanism. Kidney increases Na and urine output during high pressure 3. RAAS - should be suppressed during high pressure |
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What are 2 important epidemiological factors known to influence the prevalence of hypertension?
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1. hereditary - some people and groups have genetic predisposition to hypertension
2. Dietary Sodium Intake |
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In the US hypertension is particularly prevalent among which group?
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Blacks
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What was the RICE diet?
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fed severely hypertensive individuals a sodium free diet --> saw massive reductions in BP
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What are 4 other factors that can increase hypertension?
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1. Stress
2. Obesity 3. Physical Inactivity 4. Alcohol Consumption |
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What are the 2 broad categories of primary hypertension?
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1. Resistance hypertension
2. Compliance hypertension |
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What is resistance hypertension?
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Hypertension where fundamental abnormality is abnormal regulation of SVR.
Both systolic and diastolic pressures are increased |
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What is compliance hypertension?
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Fundamental abnormality is decreased great vessel compliance "stiff pipes"
SVR is normal. Systolic elevated, diastolic normal. |
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Compliance hypertension normally affects which age group?
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Elderly
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What is one of the main consequences of Compliance hypertension?
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Severe LV pressure overload --> Severe LVH and accelerated vascular disease
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What are the 4 steps in the "viscous cycle" of hypertension?
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1. Underlying causes - genetics, diet
2. Initial Effects - increased Na levels and SVR 3. Subsequent effects - destruction of arterioles & loss of functioning renal mass 4. Consequences - Effects cause progressive increase in SVR, more kidney damage, increased cardio load, and change in LV properties |
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What is the current hypothesis for the cause of essential hypertension?
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1. Some ppl have defect in ability to excrete Na and water
2. Natriuretic Hormon is invoked to augment renal excretion 3. Naturietic hormone acts on ALL Na/K pump and INHIBITS them 4. All cells become sodium loaded --> facilitates Na/Ca exchanger 5. Increase [Ca] in VSM and increases basal arteriole tone |
