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HYPERTENSION - Coggle Diagram
HYPERTENSION
SLO1 : Define systemic hypertension
BP
Condition of a persistent evalation of BP (140/90 mmHg
BP = CO X PR
HOW TO DECREASE BP
DECREASE PR
Increase kinins
Increase atrial natriuretic peptide
Increase prostacyclin
Decrrease beta-adrenergic
Increase NO
DECREASE CO
Decrease BV
Decrease HR
Decrease contractility
HOW TO INCREASE BP
INCREASE CO
Increase contractility
Increase BV -- by aldosterone
Increase hR
INCREASE PR
alpha-adrenergic
endothelin
thromboxane
catecholamins
angiotensin II
CO
Total vol of blood pumped by heart per min
Affected by :-
BV
Mineralcorticoids
Atrial natriuretic peptide
Na
Cardiac Factors
Heart rate
Contractility
FACTORS
Increase in HR & contractility
Mineralcorticoids
Renal fx
Inotropic effects occur via ECF vol augmentation
Na intake
CO = SV X HR
SV
Vol of blood in mm ejected fr each ventricles d/t contraction of heart muscle that compress these ventricles
SV= BV / beat
PR
Affected by :-
HUMORAL FACTORS
DILATORS
NO
KININS
PROSTAGLANDINS
CONSTRICTORS
CATHECHOLAMINES
THROMBOXANE
ANGIOTENSIN II
NEURAL FACTORS
CONSTRICTORS
ALPHA-ADRENARGIC
DILATORS
BETA-ADRENARGIC
LOCAL FACTORS
pH
HYPOXIA
AUTOREGULATION
FACTOR
TOTAL BV LENGTH
VESSEL DIAMETER
Increased wall thickness
decrease interior diameter
increase resistance
more force needed to move blood thru vessel
HIGH BP
BLOOD VISCOCITY
HR
HR = beats / min
FACTORS
Sympa nervous system
Hormones like epinerphrine fr adrenals & thyroxine
Parasympa nervous system
SLO2 : Classify hypertension into primary & secondary
Pathologic Classification
BENIGN
FACTORS
No of fxional nephrons
low grade renal damage
Genetic factors
rate of medullary blood flow
Renin-angiotensin-aldosterone system
dietary intake
Sympa activity
ASYMPTOMATIC
MECHANISM
Gene defects affect enzyme involve in aldosterone metabolism
Increase aldosterone secretion
Increase salt & water reabsorption
plasma vol expansion
HYPERTENSION
Mutations affect proteins that influence Na reabsorption
LIDDLE SYNDROME
Mutations in epithelial Na+ channel protein
Increase Na reabsorption induced by aldosterone
MALIGNANT
treatment needed to minimise organ damage / sudden death
CHARACTERISTICS
SEVERE
RENAL FAILURE
RETINAL HAEMORRHAGE & EXUDATES
AETIOLOGY
PRIMARY
IDIOPATHIC
CLASSIFICATION
GRADE 2
160-179 / 100-109 mmHg
GRADE 3
180 / >110 mmHg
GRADE 1
140-159 / 90-99 mmHg
Fr cumulative effects of multiple genetic polymorphisms
SECONDARY
fr underlying renal disease
Cushing syndrome
Primary aldosteronism
Renal artery stenosis
SLO3 : Explain causes of secondary hypertension
CAUSES
RENAL HYPERTENSION
ENDOCRINE CAUSES
COARCTATION OF AORTA
DRUG THERAPY
PATHOGENESIS -- RENOVASCULAR HYPERTENSION
Renal artery stenosis
lower glomerular flow & pressure in afferent arteriole
induce renin secretion
initiate angiotensin II mediated vasoconstriction
increase PR
increase Na reabsorption
increase bv via aldosterone mechanism
SLO4 : Describe the effects & complications of atrial systemic hypertension
COMPLICATIONS
HEART RESTING
ISOLATED DIASTOLIC HYPERTENSION
INCREASE ATHEROSCLEROTIC RISK
HEART FAILURE
AORTIC DISSECTION
ANEURYSM
RENAL FAILURE
ISCHEMIC HEART DISEASE
STROKE