Hypertension
- Leading risk factor for premature death, disability, and overall disease burden
- Most common reason for office visits and for the use of chronic prescription medications
- Most important modifiable risk factor for premature cardiovascular disease
- 1 in 3 adults worldwide have it
- Called the silent killer since most people are symptom free
- 30-70% of cases are related to genes
- Peripheral resistance = vasoconstriction
- Hypertension is multifactorial
RAAS
- Angiotensin converts to angiotensin I converts to angiotensin II which causes
vasoconstriction (immediate raise in BP) and aldosterone secretion
- Aldosterone secretion stimulates the kidney to retain sodium. Increase in blood sodium
causes posterior pituitary to release ADH which promotes reabsorption of water in the
distal and collecting tubules of the kidneys, thereby increases blood volume and CO
Gerontologic Considerations
- Accumulation of atherosclerotic plaque - clogged arteries
- Fragmentation of arterial elastins
- Increased collagen deposits
- Impaired vasodilation
- Renal dysfunction
- Results in
- Decreased elasticity/stiffening of major blood vessels (especially the aorta)
- Volume expansion
- Isolated systolic hypertension - systolic may be higher
- Leading risk factor for premature death, disability, and overall disease burden
- Most common reason for office visits and for the use of chronic prescription medications
- Most important modifiable risk factor for premature cardiovascular disease
- 1 in 3 adults worldwide have it
- Called the silent killer since most people are symptom free
- 30-70% of cases are related to genes
- Peripheral resistance = vasoconstriction
- Hypertension is multifactorial
RAAS
- Angiotensin converts to angiotensin I converts to angiotensin II which causes
vasoconstriction (immediate raise in BP) and aldosterone secretion
- Aldosterone secretion stimulates the kidney to retain sodium. Increase in blood sodium
causes posterior pituitary to release ADH which promotes reabsorption of water in the
distal and collecting tubules of the kidneys, thereby increases blood volume and CO
Gerontologic Considerations
- Accumulation of atherosclerotic plaque - clogged arteries
- Fragmentation of arterial elastins
- Increased collagen deposits
- Impaired vasodilation
- Renal dysfunction
- Results in
- Decreased elasticity/stiffening of major blood vessels (especially the aorta)
- Volume expansion
- Isolated systolic hypertension - systolic may be higher
