Hypertension(Complete solutions)
What is blood pressure?
Why is it important for it to be tightly regulated? correct answersBlood Pressure is a function of
cardiac output and peripheral vascular resistance.
If blood pressure is too low then tissues are not adequately perfused
If blood pressure is too high then blood vessels and tissues can be damaged
How is blood pressure regulated? correct answers
How does JNC 7 qualify hypertension? correct answersPrehypertension - blood pressure level at
which progression to HTN is twice as likely as a blood pressure below 120/80
How does hypertension increase risk of heart disease and stroke? correct answers
What are some important epidemiologic factors for hypertension? correct answers28% of US
adults have HTN
African Americans - HTN occurs earlier, is usually more severe, has an increased risk of
mortality & morbidity from stroke, LVH, CHF, and end stage renal disease compared to
caucasian Americans
What are some complications to hypertension? correct answersRemains asymptomatic until late
in its course
Complications:
Coronary heart disease
Cerebrovascular accidents
Cardiac hypertrophy
Heart failure
Aortic dissection
Renal Failure
Retinopathy
Untreated
-1/2 will die of ischemic heart disease or CHF
-1/3 wil die of stroke
Treatment has a dramatic effect on related diseases
How is hypertension classified? correct answersEssential (primary) hypertension
Secondary hypertension
, What are some causes of secondary hypertension? correct answers
What causes essential hypertension? correct answers95% of hypertensive cases have no
identifiable cause
Essential hypertension:
-likely a multifactorial disorder
-due to genetic mutations in blood pressure regulation
-environmental factors (stress, sodium)
What is accelerated or malignant hypertension?
What are some findings? correct answersClinical syndrome of:
-severe hypertension (Systolic blood pressure >200mm Hg, diastolic blood pressure > 120
mmHg)
-renal failure
-retinal hemorrhages and exudates, with or without papilledema
Can arise in normotensive individuals but usually superimposed on pre-exisiting benign
hypertension
What are some pathologic effects of hypertension? correct answers
How does hypertension effect the blood vessels? correct answersAccelerates atherogenesis
-results in degeneration of walls of large and medium arteries
Causes changes in small blood vessels
-Hemodynamic stress due to chronic hypertension can result in hyaline arteriolosclerosis
-Changes seen with severe hypertension include hyperplastic arterioloslerosis
What is hyaline arteriosclerosis? correct answers2 left images = normal arteriole
right image = hyaline arteriosclerosis
Result of chronic hypertension
-variable increase in arterial wall thickness
-pink hyaline thickening, narrowed lumens
-due to injury to endothelial cells
-causes leakage of plasma proteins into walls of vessel
-increased smooth muscle cell matrix synthesis due to chronic hemodynamic stress
What is hyperplastic arteriolosclerosis correct answersmicrovascular change seen in malignant
hypertension
-laminated thickening of wall
-smooth muscle cells, thickened basement membranes
-lumen is narrowed
-known as "onion skin lesion"
What is blood pressure?
Why is it important for it to be tightly regulated? correct answersBlood Pressure is a function of
cardiac output and peripheral vascular resistance.
If blood pressure is too low then tissues are not adequately perfused
If blood pressure is too high then blood vessels and tissues can be damaged
How is blood pressure regulated? correct answers
How does JNC 7 qualify hypertension? correct answersPrehypertension - blood pressure level at
which progression to HTN is twice as likely as a blood pressure below 120/80
How does hypertension increase risk of heart disease and stroke? correct answers
What are some important epidemiologic factors for hypertension? correct answers28% of US
adults have HTN
African Americans - HTN occurs earlier, is usually more severe, has an increased risk of
mortality & morbidity from stroke, LVH, CHF, and end stage renal disease compared to
caucasian Americans
What are some complications to hypertension? correct answersRemains asymptomatic until late
in its course
Complications:
Coronary heart disease
Cerebrovascular accidents
Cardiac hypertrophy
Heart failure
Aortic dissection
Renal Failure
Retinopathy
Untreated
-1/2 will die of ischemic heart disease or CHF
-1/3 wil die of stroke
Treatment has a dramatic effect on related diseases
How is hypertension classified? correct answersEssential (primary) hypertension
Secondary hypertension
, What are some causes of secondary hypertension? correct answers
What causes essential hypertension? correct answers95% of hypertensive cases have no
identifiable cause
Essential hypertension:
-likely a multifactorial disorder
-due to genetic mutations in blood pressure regulation
-environmental factors (stress, sodium)
What is accelerated or malignant hypertension?
What are some findings? correct answersClinical syndrome of:
-severe hypertension (Systolic blood pressure >200mm Hg, diastolic blood pressure > 120
mmHg)
-renal failure
-retinal hemorrhages and exudates, with or without papilledema
Can arise in normotensive individuals but usually superimposed on pre-exisiting benign
hypertension
What are some pathologic effects of hypertension? correct answers
How does hypertension effect the blood vessels? correct answersAccelerates atherogenesis
-results in degeneration of walls of large and medium arteries
Causes changes in small blood vessels
-Hemodynamic stress due to chronic hypertension can result in hyaline arteriolosclerosis
-Changes seen with severe hypertension include hyperplastic arterioloslerosis
What is hyaline arteriosclerosis? correct answers2 left images = normal arteriole
right image = hyaline arteriosclerosis
Result of chronic hypertension
-variable increase in arterial wall thickness
-pink hyaline thickening, narrowed lumens
-due to injury to endothelial cells
-causes leakage of plasma proteins into walls of vessel
-increased smooth muscle cell matrix synthesis due to chronic hemodynamic stress
What is hyperplastic arteriolosclerosis correct answersmicrovascular change seen in malignant
hypertension
-laminated thickening of wall
-smooth muscle cells, thickened basement membranes
-lumen is narrowed
-known as "onion skin lesion"
