Monday, March 20, 2017

Pathological and Clinical Consequences of Hypertension

Yet another PHAR3303 lecture that covers a lot of content from previous posts! Makes things easy for me :)

Aetiology of Hypertension

See earlier post: Vascular Disorders

Hypertension and the Brain

See earlier post: Acute Neurological Conditions

Hypertension and the Heart

Hypertension can cause hypertrophy of the left ventricle (i.e. the left ventricle gets bigger and stronger because it has to do more work). Unfortunately, "bigger and stronger" doesn't always mean "better"- the thicker heart muscle can compress the arteries surrounding the heart, plus bigger muscles need a bigger blood supply, so the ventricle won't get the amount of blood that it needs. Also, the thickening of the ventricle walls means that there is less room for the ventricle to hold blood (which leads to the diastolic dysfunction briefly mentioned here). Over time, the left ventricle may weaken and thin out, leading to a condition called dilated cardiomyopathy. This can then cause heart failure, low blood pressure and death.

Hypertension and the Eye

I don't think I've covered this earlier (at least not in detail), but this lecture doesn't go into depth either. Basically all it says is that it's easy to see the blood vessels in the eye with an ophthalmoscope, and hypertension can make them look weird. The most important treatment method is to lower the blood pressure, but laser eye treatment can also help.

Hypertension and the Kidney

Kidneys have lots of little blood vessels that can be readily damaged by hypertension. This can result in renal failure, which has been described in detail (probably more detail than you need for this unit) here. Just like with the aforementioned eye problems, kidney problems related to hypertension can be treated by using drugs for high blood pressure, like ACE inhibitors and ARBs (angiotensin receptor blockers). One interesting thing, however, is that not all ethnicities seem to respond to these drugs in the same way (apparently they seem to be less effective for African-Americans).

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