29. Consequences of hypertension

Page created on October 6, 2018. Last updated on May 24, 2019 at 19:01

All complications and consequences of hypertension are associated with cardiovascular changes. The most common causes of death due to hypertension are:

  • Central nervous system related
    • Stroke
  • Congestive heart failure
  • Coronary artery diseases
  • Chronic renal failure

The most important clinical consequences of hypertension are:

  • Cardiovascular complications
    • Left ventricle hypertrophy
    • Congestive heart failure
    • Aortic dissection
    • Ischemic heart disease
      • Angina pectoris
      • Acute myocardial infarction
      • Sudden cardiac death
  • CNS-related
    • Haemorrhagic stroke
    • Ischemic stroke
    • Hypertensive encephalopathy
  • Renal failure
    • Hypertensive nephropathy
    • Nephrosclerosis
    • End-stage renal failure
  • Hypertensive retinopathy, blindness

The high pressure inside the vessels damage the tunica intima, especially in small vessels and vessels that have sharp turns. This endothelial damage is the beginning of atherosclerosis. The damage might continue through the tunica media and contribute to form aneurysms.

The increased afterload caused by hypertension causes concentric left ventricular hypertrophy as explained here.

At about every 10 mmHg increase in blood pressure the risk of stroke increases by 10%. If the increase in blood pressure is rapid the can’t cerebral autoregulation compensate, which causes an increase in intracranial pressure.

In hypertension does the renal arteries become sclerotic (nephrosclerosis). This decreases the glomerular filtration and causes ischaemia of the kidney. This can cause renoparenchymal hypertension.

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