高血压病理学ppt课件

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1、PathologyofHypertension:Dr.VenkateshM.Shashidhar.SeniorLecturerinPathologyFijiSchoolofMedicineHypertension-IntroductionSilentKiller–painless–complicationsdizziness,headache,andvisualdifficulties,Itistheleadingriskfactor–MI,DM,StrokeResponsibleforthemajorityofoffic

2、evisits,Numberonereasonfordrugprescription.25%ofpopulation,<35%aware.<5%..!Complicationsbringtodiagnosisbutlate…Chronic,vascular&endorgandamage.Introduction“Sustainedincreaseinbloodpressure”Systolic>140,Diastolic>90mmofHg*Normal*<130<85(120/80+/-10/5)Mild+20,Moder

3、ate+40Severe+80Malignant->210/120RegulationofBP:BP=CardiacOutputxPeripheralResistanceEndocrineFactorsRenin,Angiotensin,ANP,ADH,Aldosterone.NeuralFactorsSympathetic&ParasympatheticBloodVolumeSodium,Mineralocorticoids,ANPCardiacFactorsHeartrate&Contractility.Control

4、ofBloodPressure:BPCardiacOutputPeripheralResistanceBloodVolumeNa+,AldosteroneVasoconstrictorsAngiotensinIICatecholaminesVasodilatorsPg&KininsLocalFactorspH,HypoxiaNeuralFactorsAdrenergic–ConsßAdrenergic-DilCardiacFactorsRate&Contract..HumoralFactorsEtiologicClassi

5、fication:PrimaryorEssentialHypertension(95%)SecondaryHypertension(5-10%)Renal–GN,RAS,RenintumorsEndocrine–Cushing,OCP,ThyrotoxicosisMyxdema,Pheochromocytoma,Acromegaly.Vascular–CoarctationofAorta,PAN,Aorticinsufficiency.Neurogenic–Psychogenic,Intracranialpressure,

6、olyneuritisetc.PathogenesisofHypertension:?PathogenesisinEssentialhypertension-MultifactorialIncreasedbloodvolume-SodumretentionADH,Aldosterone.Increasedsympathetictone-Adrenaltumours,sympatheticstimulation.Increasedvasoactivehormones-Cushings,Pheochromocytoma,Pat

7、hogenesisofRenovascularHTN:GFRReninbyJGAAngiotensinIIVasoconstrictionP.ResistanceSodiumRetentionBloodVolumeAldosteroneHypertensionConsequencesofHypertension:BloodVesselsAtherosclerosisanditscomplicationsaneurism,Dissection,Rupture,necrosis.Arteriolosclerosis,He

8、artHypertensivecardiomyopathy,IHD,MI.KidneyBenign/Malignantnephrosclerosis.InfarctionEyes:HypertensiveretinopathyBrain:Haemorrhage,infarction,splinter&L