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9 Cards in this Set

  • Front
  • Back
What is the def of HTN, how is it diagnosed
Normal to systolic < 120; diastolic < 80

Pre-hyperT to systolic 120 – 139; diastolic 80 – 89

1st stage to systolic 140 – 159; diastolic 90 – 99

2nd stage to systolic ≥ 160; diastolic > 99

Diagnosed by average of 2 or more reading on 2 or more visits
whats the difference between primary and secondary htn
Primary (“essential”) hypertension has no known cause [95%]
Secondary hypertension is a result of some other pathology like renal disease, etc. [5%]
whats the difference between benign and malignant htn
Benign: usually asymptomatic, affects middle age – elderly, common (95%), very slow course

Malignant: symptomatic, affects young – middle age, uncommon (5%), has a very rapid course, progressing to ESRD, retinal hemorrhages, etc.
how is blood pressure regulated
Bp=Co X PR
Co regulated by cardiac (HR, contractility), BV (Na, mineralocorticoids, ADH)
PR regulated by humoral (const: ang II, catech, endothelin), local (autoreg, ionic), and neural (const alpha adre, dilat beta adre)
how do the discussed genetic disorders affect RAAS
GRA: ectopic production of aldosterone, under control of ACTH Chromosome 8q
AME: inactive β-hydroxysteroid dehydrogenase to excess cortisol Chromosome 16q
Liddle Syndrome: gain of function causes sustained activity of Na+ channels Chromosome 16p
what major environmental factos contribute to htn
Age, Race, Gender, Lifetsyle

Note: prevalence of hypertension is highest in African Americans
what are the major causes of secondary btn
Renal artery stenosis; renal parenchymal disease; pheochromocytoma; primary hyperaldosteronism (Conn syndrome)
what are the systemic affects of benign htn
LVH; LAE; eventual diastolic dysfunction; ischemic heart disease; accelerated atherogenesis; nephrosclerosis (due to glomerular hyperfiltration (hyalinized walls), as well as ischemia), cerebrovascular hemorrhage, stroke, dementia, CB aneurysms, retinal exudates and hemorrhage

Note: there is preferential vasoconstriction of efferent arterioles à hyperfiltration

Note: risk for ESRD is highest in African Americans
what are the systemic affects of malignant htn
Malignant nephrosclerosis (“onion skin”); hypertensive encephalopathy; papilledema and retinal hemorrhages