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9 Cards in this Set
- Front
- Back
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What is the def of HTN, how is it diagnosed
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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 |
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whats the difference between primary and secondary htn
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Primary (“essential”) hypertension has no known cause [95%]
Secondary hypertension is a result of some other pathology like renal disease, etc. [5%] |
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whats the difference between benign and malignant htn
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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. |
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how is blood pressure regulated
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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) |
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how do the discussed genetic disorders affect RAAS
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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 |
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what major environmental factos contribute to htn
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Age, Race, Gender, Lifetsyle
Note: prevalence of hypertension is highest in African Americans |
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what are the major causes of secondary btn
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Renal artery stenosis; renal parenchymal disease; pheochromocytoma; primary hyperaldosteronism (Conn syndrome)
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what are the systemic affects of benign htn
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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 |
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what are the systemic affects of malignant htn
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Malignant nephrosclerosis (“onion skin”); hypertensive encephalopathy; papilledema and retinal hemorrhages
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