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Hypertension (Pathoma) (Systemic HTN (Divided into primary or secondary…
Hypertension (Pathoma)
Increased BP
may involve pulmonary or systemic circulation
Systemic HTN
≥140/90 mmHg
isolated systolic or diastolic HTN qualifies
Divided into primary or secondary types based on etiology
Primary HTN
unknown etiology (95%)
risk factors
age
race
African Americans
Obesity
Stress
Lack of physical activity
high sodium diet
systemic pressure is function of stroke volume
Ns increases blood volume and TPR
Na affects systolic and diastolic BP
Secondary HTN
due to identifiable causes (5% cases)
Renal artery stenosis
increases plasma renin
Unilateral atrophy of affected kidney
JGA makes renin and kicks off RAAS
ATII effects(2)
directly contracts efferent arteriole
increases GFR
adrenal release of aldosterone
1 more item...
affected kidney becomes smaller due to less blood flow
Causes:
Atherosclerosis (elderly males)
Fibromuscular dysplasia (young females)
developmental defect of blood vessel wall resulting in
irregular thickening of large and medium sized arteries esp. renal a.
Benign or malignant classification
Benign HTN
mild/ moderate elevation in bp
clinically silent: damages vessels and organs over time
Malignant HTN
severe elevation in BP >200/120mmHg
may arise from preexisting benign HTN, or de novo (no hx of HTN)
Present w/ actue end organ damage
classically: Acute renal failure, HA, papilledema
Medical emergency
