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Hypertension (Pathophysiology of Alterations (Complicated interaction of…
Hypertension
Epidemiology
BP is leading risk factor for disease/disability worldwide
“J” shaped curve association between BP and cardiovascular risk
First thought to be uncontrollable
Risk factor for several diseases
Pathophysiology of Alterations
Complicated interaction of genetics and environment mediated neurohumoral effects
Involves SNS
RAAS
Natriuretic peptides
Inflammation
Endothelial dysfunction
Obesity-related hormones and insulin resistance
Risk factors
Obesity
Smoking
Stress
Multiple Comorbidities
Damage associated molecular patterns
Genetics
Clinical Presentation
Primary or secondary
Secondary caused by underlying disease process
Early signs have no manifestations except elevated BP
Some never have signs,
Others become very ill and can cause death
Diagnosis
Framingham Heart study helped define HTN as systolic BP > 160
Lower DBP of 10mm HG or more associated with decreased Coronary heart disease
Attained by using Sphygmomanometer and stethoscope on at least two separate occasions
Treatment
Pharmacologic intervention
Diet control (especially lower salt intake)
Exercise
Smoking cessation
