Understanding Hypertension and Its Causes
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Questions and Answers

What blood pressure reading typically indicates hypertensive urgency?

  • >200/130 mmHg
  • >160/100 mmHg
  • >140/90 mmHg
  • >180/120 mmHg (correct)
  • Which of the following is considered a non-modifiable risk factor for hypertension?

  • Tobacco Use
  • High diet salt intake
  • Obesity
  • Age (correct)
  • Which symptom might be associated with severe cases of hypertensive urgency?

  • Dizziness
  • Visual disturbances (correct)
  • Muscle pain
  • Nausea
  • What is a significant indicator of potential underlying vascular disease when measuring blood pressure between arms?

    <p>15 mmHg difference</p> Signup and view all the answers

    Which of the following lab tests is NOT commonly performed to diagnose hypertension?

    <p>Complete Blood Count (CBC)</p> Signup and view all the answers

    What defines hypertension according to conventional standards?

    <p>Sustained increase in blood pressure ≥140/90 mmHg</p> Signup and view all the answers

    What percentage of patients are typically found with low-renin essential hypertension?

    <p>Approximately 20%.</p> Signup and view all the answers

    What is one of the main causes of secondary hypertension?

    <p>Endocrine diseases</p> Signup and view all the answers

    What characterizes a hypertensive emergency?

    <p>Blood pressure above 180/120 mmHg with organ damage</p> Signup and view all the answers

    Which of the following is NOT a typical classification for hypertension?

    <p>Moderate hypertension</p> Signup and view all the answers

    What is a common risk factor that doubles cardiovascular disease risk with every 20/10 mmHg increase?

    <p>Blood pressure of 115/75 mmHg</p> Signup and view all the answers

    Which mutation is associated with increased aldosterone secretion and salt and water resorption?

    <p>Aldosterone synthase</p> Signup and view all the answers

    Which of the following conditions is associated with increased cardiac output leading to hypertension?

    <p>Vasoconstrictor hypertension</p> Signup and view all the answers

    Study Notes

    Definition of Hypertension

    • Sustained increase in blood pressure greater than or equal to 140/90 mmHg.
    • Leading risk factor for death worldwide.
    • Increases risk of stroke, myocardial infarction, heart failure, renal failure, and dissecting aortic aneurysm.
    • Cardiovascular disease risk starts at 115/75 mmHg and doubles with every 20/10 mmHg increase.

    Pathogenetic Mechanisms of Hypertension

    • Raised catecholamine levels.
    • Increased blood volume (volume hypertension) and arteriolar constriction (vasoconstrictor hypertension).
    • Increased cardiac output.
    • Low-renin essential hypertension (20% cases) due to altered responsiveness to renin release.
    • High-renin essential hypertension (15% cases) due to decreased adrenal responsiveness to angiotensin II.

    Causes of Hypertension

    • Primary hypertension (90-95%): Also known as essential hypertension, the cause is usually idiopathic.
    • Secondary hypertension (5-10%): Caused by underlying conditions such as kidney disease, endocrine disorders, cardiovascular disease, neurological disorders, and medications.
    • Medications that can cause secondary hypertension include NSAIDs, corticosteroids, vasopressin, and others.

    Genetic Basis of Hypertension

    • Gene defects in aldosterone metabolism can increase aldosterone secretion, leading to increased salt and water resorption and plasma volume expansion.
    • Mutations in proteins involved in sodium resorption can lead to conditions like Liddle syndrome.

    Clinical Classification of Hypertension

    Category Systolic (mmHg) Diastolic (mmHg)
    Normal < 120 < 80
    Prehypertension 120-139 80-89
    Hypertension: Stage 1 140-159 90-99
    Hypertension: Stage 2 >160 >100
    Isolated Systolic Hypertension >140 < 90
    Malignant Hypertension >200 >140

    Hypertensive Crises

    • Hypertensive Emergency:
      • Severe blood pressure increase (usually above 180/120 mmHg).
      • Accompanied by acute target organ damage.
      • Life-threatening and requires immediate medical intervention, often in a hospital setting.
    • Hypertensive Urgency:
      • Significant elevation in blood pressure (typically >180/120 mmHg).
      • Not accompanied by acute target organ damage.
      • Requires prompt medical attention to prevent progression to a hypertensive emergency.

    Risk Factors for Hypertension

    • Non-modifiable:
      • Age
      • Sex
      • Family History
      • Ethnicity
    • Modifiable:
      • High dietary salt intake
      • Diet high in fat and low in nutrients.
      • Physical inactivity
      • Obesity
      • Alcohol consumption
      • Tobacco use
      • Stress

    Symptoms of Hypertension

    • Typically asymptomatic.
    • Severe cases may present with headache, visual disturbances, or evidence of target organ damage.
    • Consequences of target organ damage can affect the heart, eyes, kidneys, brain, and peripheral vasculature.

    Diagnostic Tests for Hypertension

    • Sphygmomanometer: Use a well-calibrated sphygmomanometer.
    • Blood pressure measurements in sitting & standing positions: The arm should be supported at the level of the heart.
    • Blood pressure measurements in both arms: If a difference of 20 mmHg is found, repeat measurements. Use the arm with the highest value for monitoring.
    • Blood pressure differences between arms: A 15 mmHg difference may indicate underlying vascular disease and an increased risk of all-cause and cardiovascular mortality.
    • Repeat readings: If the reading is >140/90 mmHg, confirm hypertension by ambulatory blood pressure monitoring (ABPM).

    Lab Tests for Hypertension

    • KFT (Kidney Function Test):
    • LFT (Liver Function Test):
    • Electrolytes:
    • Other tests: ECG, Echo, eGFR

    General Blood Pressure Targets

    Category Clinic BP Target ABPM/HBPM Target
    People younger than 60 years
    People 60 years and older

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    Description

    This quiz explores the definition, pathogenesis, and causes of hypertension. Learn about the different types of hypertension, risk factors, and the physiological mechanisms behind elevated blood pressure. Test your knowledge on this critical health topic and its implications for cardiovascular disease.

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