Pathophysiology of Hypertension
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- ______ is the root cause of atherosclerosis
- Endothelial damage
- 6 characteristics of Angiotensin II
- Vasoconstrictor Growth promoter Prothrombic Proinflammatory Pro-oxidant Pro-atherogenic
- If a patient has high renin, they are at higher/lower risk for an MI.
- Higher.
- Conditions associated with hypertension
- Obesity Endothelial dysfunction Decreased arteriolar compliance Diabetes Neurohormonal dysfunction Changes in renal function Abnormal blood clotting Abnormal lipid metabolism Accelerated atherogenesis
- *How does HTN lead to atherosclerosis?
- HTN increases the chance for endothelial injury, since narrowing blood vessels/more pressure causes turbulent blood flow. If the endothelial cells are injured and cholesterol is around, it can form a plaque and lead to atherosclerosis.
- HTN is the root cause of ___________
- Atherosclerotic disease
- HTN Therapies
- 1. Block Renin-Angiotensin System 2. Decrease blood volume (diuretics)
- Standard therapy for HTN
- ACE-Inhibitors or AT1 receptor blockers (ARBs)
- What is the problem with using diuretics as a treatment for HTN?
- Diuretics just cause a loss of blood volume, which reduces the blood pressure. However, this reduction in blood pressure is sensed by the baroreflex receptor system, which stimulates the SNS, which again stimulates renin release and activation of the RAS. So when giving patients diuretics, you also have to give an ACE-inhibitor or ARB to block the RAS system. This combination therapy is effective in lowering the BP.
- Drugs that can be used alone to treat hypertension
- ACE inhibitors, ARBs, Beta-blockers These drugs all inhibit SNS, so inhibit vasoconstriction, or inhibit RAS directly.
- Drugs that cannot be used alone to treat hypertension
- Diuretics, Ca2+ channel blockers, vasodilators. All of these drugs reduce blood volume, which reduces blood pressure. However, they can\'t be used alone b/c they do not stop SNS activation. Baroreceptors will sense the decrease in blood pressure, and stimulate the SNS to re-activate the RAS system.