Blood pressure

Beschreibung

Reference: Robbin's Basic Pathology Chapter 9
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Zusammenfassung der Ressource

Blood pressure
  1. Major regulator: Renin
    1. Juxtaglomerular cells
      1. Cleaves Angiotensinogen to AT-1
        1. AT-1 to AT-2
          1. Stimulates adrenal gland to secrete aldosterone
            1. Increases blood volume
              1. -ve feedback by Myocardial natriuretic peptide
            2. Increases sodium resorption
              1. Vasoconstriction
          2. Benign Hypertension
            1. Malignant Hypertension
              1. Hyperplastic arteriosclerosis
                1. Decreased sodium excretion
                  1. Increased blood volume and blood pressure
                  2. Genetic factors/ Environmental factors
                    1. Atherosclerosis
                      1. Atheroma
                        1. Cholesterol, cholesterol esters, necrotic debris and fibrotic caps
                        2. Thrombosis
                          1. Risk Factors
                            1. Modifiable
                              1. Hyperlipidemia/ hypercholesterolemia
                                1. Good cholesterol
                                  1. HDL. HDL mobilzes the cholesterols from plaques to the liver
                                    1. Exercise and ethanol increases HDL
                                      1. Smoking and obesity decreases HDL
                                    2. Bad cholesterol
                                      1. LDL. LDL distributes the cholesterol in the peripheral tissues
                                        1. Statins lower the circulating cholesterol
                                          1. Statins lower CRP levels
                                            1. CRP is synthesised by liver. It is a biomarker which predicts the risk of MI.
                                    3. Hypertension
                                      1. Ischemic heart disease
                                        1. Left ventricular hypertrophy
                                        2. Smoking
                                          1. Diabetes mellitus
                                            1. Atherosclerosis related GANGRENE
                                              1. Myocardial infarction
                                            2. Constitutional/ nonmodifiable
                                              1. Genetics
                                                1. Familial hypercholesterolemia
                                                2. Age
                                                  1. 40-60 yrs
                                                  2. Gender
                                                    1. Males are more prone. Postmenopausal women are also at more risk compared to premenopausal
                                                3. Coronary Artery Disease
                                                  1. Lipoprotein-a : Apolipoprotein B100 and Apolipoprotein-a
                                                  2. Atherogenesis
                                                    1. Endothelial injury
                                                      1. Endothelial dysfunction
                                                        1. Monocyte-macrophages
                                                          1. Platelet adhesion
                                                            1. Smooth muscle recruitment
                                                              1. Lipid accumulation
                                                                1. Fatty streaks
                                                                  1. Atherosclerotic plaques
                                                                    1. Smooth muscle cells, T-cells and macrophages
                                                                      1. Intracellular and extracellular lipid accumulation
                                                                        1. ECM, collagen, elastin, proteoglycans
                                                                          1. LEADS TO THROMBOSIS
                                                                            1. EMBOLISM
                                                                              1. Plaque rupture
                                                                                1. Plaque erosion
                                                                                  1. Plaque hemorrhage
                                                                        2. Hyaline arteriosclerosis
                                                                          1. Nephrosclerosis
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