Dz of Blood vessels
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| How is systemic hypertension (HTN) or aka. High blood pressure defined as? | Systolic above 140, OR
Diastolic above 90
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| Is hypertension multifactorial inheritance? | Yes! BP is a complex trait determined by interaction of multiple genetic & environmental factors
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| BP is product of what? | cardiac output & peripheral resistance
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| what determines cardiac output & peripheral resistance? | cardiac output - stroke volume & heart rate
peripheral resistance - arterioles thru opposing vasoconstrictor & vasodilator
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| Kidney plays an impt. role in BP, mainly thru what? | renin-angiotensin axis
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| what is the epidemiology of HTN? | Very common, 25% of general population.
50% die w/ ischemic heart dz or congestive heart failure.
33 % die w/ stroke.
5 % w/ malignant hypertension(rapidly rising BP), die of renal failure.
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| HTN is an impt. risk factor for what dzs? | 1. ischemic heart dz
2. cerebrovascular accident (stroke)
3. congestive heart failure
4. renal failure
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| Etiologic types of HTN: describe them. | 1. Essential HTN (90-95%) = considered idiopathic & primary
2. Secondary HTN (5-10%) = happens secondary to other dz, esp to renal dz/narrowing of renal artery.
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| Describe: Benign HTN vs. Malignant HTN | Benign HTN = fairly stable over yrs - decades, lives long life.
Malignant HTN (accelerated HTN) = BP rises rapidly, death w/in 1-2 yrs, diastolic >120, renal failure, retinal hemorrhages.
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| what are some mechanisms for Essential HTN? (they are no single mechanism that are responsible) | 1. Reduced renal sodium excretion
2. Increased Vascular resistance
3. Genetic factors
4. Environmental influences
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| Define: 1. Hyaline arteriolosclerosis 2. Hyperplastic arteriolosclerosis |
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| What is Arteriosclerosis? | general term of 3 types of vascular dz which cause thickening & inelasticity of arteries.
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| what are types of arteriosclerosis? | 1. arteriolosclorosis
2. Monkeberg medial calcific sclerosis
3. atherosclerosis
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| what is Arteriolosclerosis? | Dz. of small arteries & arterioles.
occurs often w/ hypertension & diabetes mellitus.
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| what is Monkeberg medial calcific sclerosis? | calcifications in media of medium sized muscular arteries.
typically age >50yrs.
vessels may be hard to palpate & interesting radiograph.
trivial dz & not ass. w/ clinical dz.
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| what is atherosclerosis? | Formation of atheromas(fibrofatty plaques at intima)
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| Athromas produce...? | 1. vascular narrowing - b/c protrude into lumen
2. degenerative changes - b/c weakens the vessel wall
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| Most serious consequences of artherosclerosis is seen at...? | 1. coronary artereis
2. cerebral vessels
3. aorta
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| what's the epidemiology of atherosclerosis? | 1. Major complication is death/ disability from heart attacks & stroke
2. cause 1/3 of death in US
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| what are the constitutional risk factors for atherosclerosis? | 1. Genetics (mostly related to polygenic traits for hypertension & diabetes)
2. Age
3. Gender
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| what are the modifiable major risk factors for atherosclerosis? (list in rank) | 1. hyperlipidemia/Hypercholesterolemia
2. Hypertension
3. cigarette smoking
4. Diabetes mellitus
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| Describe the pathogenesis of ATH. | 7 steps- look notes
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| sites of predilection for ATH. | 1. lower abdominal aorta
2. coronary arteries
3. popliteal arteries.
4. internal carotid arteries
5. circle of Willis
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Created by:
dsung
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