HYPERTENSIVE CARDIOVASCULAR DISEASE

Precipitating/ Predisposing Factors:

1. Environmental – Lifestyle, Diet, Work Related..
2. Genetic – Salt sensitivity, Family Hx of HPN etc
3. Primary Disease (Specific Organ or Systemic) – DM, Cushing's, Renal Disease..

Increases Systemic Pressure/ Increased Cardiac Output

(2º to Hyperlipidemaia, Plaque Formation, Renal Impairment, or Essential/ 1º HPN)

Increased Preload

Excessive Cardiac Workload–(Hypertensive State) ------ (palpitations, dizziness, vertigo)

Cardiac Compensation from Prolonged High Pressure

CONCENTRIC LEFT VENTRICULAR HYPERTROPHY

Reduced LV Compliance
(Impaired LV Function + Ventricular Cavity Dilates)

Impaired Diastolic Filling & Increased O2 Demand ----------- Angina Pectoris

Further LV Hypertrophy

Individual myocyte increase in size –

(increased distance of O2 & Nutrient Diffusion
from Adjacent Capillaries)

Coronary Atherosclerosis + Hypertensive State

Increased O2 Demand & LV Dysfunction

(Conduction Abnormalities, Specific Valvular Diseases)

Myocardial Ischemia

Continued Hypoxia and Hypoxemia

MYOCARDIAL INFARCTION

LEFT-SIDED FAILURE
 Left Ventricular Dysfunction

Decreased Pulmonary Clearance due to Increased Systemic Pressure

+ LV Failure

Increased Blood Volume in the Lung

Increased Hydrostatic Pressure in the Pulmonary Vascular Bed

Transudation of Liquid into the Interstitial Space

Reduced Lung Compliance

Stimulation of Juxtacapillary (J) Receptors in the Alveolar Interstitial Space

Thickening of the Small Pulmonary Vessel Walls + Increase in Perivascular Pressure + Fibrous Tissue

Further Decrease in the Compliance

PULMONARY EDEMA
(Owing to Vesselsm Airways, + Fluid within the Interstitial Space Compromises the Lumina
of Small Airways)

Increased Airway Resistance --------- further Dyspnea

Diminution in Compliance + Increased Airway's Resistance

ADVANCED STAGE OF CONGESTIVE HEART FAILURE

(Increased Pulmonary & Systemic Venous Pressure)

Hydrothorax

Other End Organ Damage

(Secondary Renal Failure, HPN Encephalopathy, CVD, Liver Failure etc..)

NB:
Ginsugpon ko nlng, pki separate nlng, nbutangan ko nmn broken lines across kun wer mo pwd mtunga.. hehe..=) Xenxia
medyo pdali, medyo shortcut..Ü