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    CVS 1

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    Tanuza
    This document summarizes different types of hypertension including essential, isolated systolic, iatrogenic, secondary, and malignant hypertension. It notes that hypertension is a major risk factor for stroke, heart disease, kidney disease and other conditions. Each 2 mmHg rise in systolic blood pressure increases mortality risks. It also defines systolic and diastolic blood pressure and describes the different causes and diagnoses of various types of hypertension.

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    CVS 1

    Uploaded by

    Tanuza
    44 views18 pages
    This document summarizes different types of hypertension including essential, isolated systolic, iatrogenic, secondary, and malignant hypertension. It notes that hypertension is a major risk factor for stroke, heart disease, kidney disease and other conditions. Each 2 mmHg rise in systolic blood pressure increases mortality risks. It also defines systolic and diastolic blood pressure and describes the different causes and diagnoses of various types of hypertension.

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    Cardiovascular (HTN)

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    This document summarizes different types of hypertension including essential, isolated systolic, iatrogenic, secondary, and malignant hypertension. It notes that hypertension is a major risk factor for stroke, heart disease, kidney disease and other conditions. Each 2 mmHg rise in systolic blood pressure increases mortality risks. It also defines systolic and diastolic blood pressure and describes the different causes and diagnoses of various types of hypertension.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    44 views18 pages

    CVS 1

    Uploaded by

    Tanuza
    This document summarizes different types of hypertension including essential, isolated systolic, iatrogenic, secondary, and malignant hypertension. It notes that hypertension is a major risk factor for stroke, heart disease, kidney disease and other conditions. Each 2 mmHg rise in systolic blood pressure increases mortality risks. It also defines systolic and diastolic blood pressure and describes the different causes and diagnoses of various types of hypertension.

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    © All Rights Reserved
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    You are on page 1of 18

    Cardiovascular System

    Hypertension (high blood pressure)


    Essential
    Isolated systolic
    Iatrogenic
    Secondary
    Malignant/accelerated
    Major risk factor for :

    ischaemic and haemorrhagic stroke


    myocardial infarction
    heart failure
    chronic kidney disease
    cognitive decline
    premature death

    - Each 2mmHg rise in systolic blood pressure associated with a 7% increased risk
    of mortality from ischaemic heart disease and a 10% increased risk of mortality
    from stroke.
    Systolic pressure: the higher measurement when the
    heart beats, pushing blood through the arteries

    Diastolic pressure: the lower measurement when the


    heart rests between beats
    Essential hypertension
    Primary / idiopathic hypertension
    No known cause
    About 95% of the cases
    Multifactorial aetiology:
    * Genetic factors
    * Environmental factors (obesity; alcohol intake;
    sodium intake)
    Isolated systolic hypertension
    diastolic (the bottom number of a blood pressure
    measurement) less than 90 millimeters of mercury
    (mm Hg) and a systolic number (the top number of a
    blood pressure measurement) greater than 140 mm
    Hg
    Associated with two- to three- fold increase in cardiac
    mortality
    Found particularly in elderly hypertensives, since SBP
    (systolic blood pressure) is known to rise with advancing
    age, whereas DBP usually levels off and then tends to
    decrease in the elderly
    Iatrogenic hypertension
    Iatrogenic - Due to the activity of a physician or therapy
    White coat syndrome: phenomenon in which patients exhibit a blood
    pressure level above the normal range, in a clinical setting, though
    they don't exhibit it in other settings

    Drug-induced hypertension: variety of drugs and chemical substances


    have been shown to elevate blood pressure
    - steroids
    - oral contraceptives containing oestrogens
    - immunosuppressive agents
    - sympathomimetic agents
    Secondary hypertension
    Blood pressure elevation is the result of a specific and potentially treatable cause
    (consequence of specific disease or abnormality leading to sodium retention and/or
    peripheral vasoconstriction)

    Found in about 5% of the cases


    Renal disease:
    - Polycystic kidney disease
    - Renal vascular disease
    - Diabetic nephropathy

    Endocrine disease:
    - Cushings syndrome
    - Thyroid disease
    - Acromegaly
    - Phaeochromocytoma
    Malignant hypertension
    Occurs when blood pressure rises rapidly
    Severe hypertension (diastolic BP >120mmHg)
    Fibrinoid necrosis microvascular damage with necrosis in
    walls of small arteries and arterioles
    Causes rapidly progressive end organ damage (renal
    failure; heart failure)
    Retinopathy - Changes in retina (cotton wool spots, hard
    exudates, papilloedema, haemorrhages)
    High risk of cerebral oedema and haemorrhage with
    resultant hypertensive encephalopathy
    Diagnosis
    If the clinic blood pressure is 140/90 mmHg or higher,
    offer ABPM (ambulatory blood pressure monitor) to
    confirm the diagnosis of hypertension
    If a person is unable to tolerate ABPM, HBPM (home
    blood pressure monitor) is a suitable alternative
    Cardiovascular risk assessment
    QRISK2 is the recommended formal risk assessment tool
    to assess CVD risk
    online assessment tool for estimating the 10-year risk of
    having a cardiovascular event, in people who do not
    already have heart disease
    Adults aged 85 years and over and those with existing
    CVD, type 1 diabetes, chronic kidney disease or familial
    hypercholesterolaemia should be considered to be at an
    increased risk of CVD events without using QRISK2
    NICE guideline
    References:
    http://ndt.oxfordjournals.org/content/16/6/1095.full
    https://www.nice.org.uk/guidance/cg127
    https://cks.nice.org.uk/hypertension-not-diabetic
    Kumar and Clarks Clinical medicine
    Davidsons Principles and Practice of Medicine
    HYPOTENSION
    Orthostatic/Postural hypotension
    Hypovolemic shock
    Cardiogenic shock

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