Hypertension

1. HYPERTENSION
Subject Pathophysiology
Presented by: Lovekesh Singh

2. INTRODUCTION
• Hypertension is the condition in which the blood pressure of the person is
increased/ prolongs for the long term and causes health problems of the
heart. is known as hypertension.
• In this the force of on the walls of the arteries is too much
• High blood pressure or rise in BP usually shows no or very less symptoms
• If hypertension is not treated then it often leads to serious problems of the
heart like stroke, CHF, etc.
• It usually occurs due to:
1.more salt rich diet
2.No exercise
3.Obesity
4.More oily diet
5.Eating too much fast food

3. Pre-hypertension
• Pre- before. Hyper- more, tension-force
• It is defined as the elevation in BP slightly from the
normal blood pressure is known as pre-hypertension.
• Systolic BP: 120-139 mmHg
• Diastolic BP: 80-89 mmHg

4. Stages of Hypertension
Stages Systolic BP
range
Diastolic BP
range
Normal 120 mmHg 80mmHg
Pre-hypertension 120-139mmHg 80-89mmHg
1◦ hypertension 140-159mmHg 90-99mmHg
2◦ hypertension 160- above 100-Above

5. Etiology of Hypertension
Hypertension
1◦ Hypertension 2◦ Hypertension
• Also known as
essential
hypertension
• Most common
• Do not have any
cause
• Less common
• This is caused by any
medical conditions
like diabetes and
kidney failure

6. Risk Factors that leads
to hypertension
1. Obesity
2. Salt sensitivity
3. Cushing syndrome and tumours
4. Heredity
5. Age and sex
6. Chronic smoking and alcoholism
7. Oral contraceptives

7. Pathophysiology of hypertension
1. Sympathetic nervous system activities
a. The sympathetic nervous system acts on B.P in various ways
• When B.P increases, there is activation of sympathetic nervous system
• More/higher the sensitivity of sympathetic nervous system, more it causes
vasoconstriction via release of adrenaline and it increases the B.P
b. Adrenaline released via sympathetic nervous system can activates the JG cells in
kidney.
Which results in release of enzymes called RENIN
Renin increases the production of Angiotensin-II
Causes vasoconstriction directly or via activation of Aldosterone
Increases Na+ retention (means to controls the excretion of Na+ through
urine)
Increase BLOOD VOLUME
Increase B.P

8. Cont…
c. Increased release of adrenaline is directly acts on heart
It acts on SA NODE
Activation of SA node will increase the heart rate which can further increase the CARDIAC
OUTPUT
Rise in B.P
Adrenaline also act on contractile cells of the ventricles
Increases the force of contraction of the ventricles
Increases the stroke volume that further increases the CARDIAC OUTPUT
Increase in B.P

9. Activities of the RENAL SYSTEM
• During increase in sodium retention due to any kidney disease
Increase in Blood volume
Increase in Blood Pressure
Inhibits the kidney cells to release RENIN and it cannot further activates
ANGIOTENSIN SYSTEM
That’s why it is also known as LOW RENIN HYPERTENSION

10. Activities of the VASCULAR ENDOTHELIUM
• Vascular endothelium is a single layered lines of the BLOOD VESSELS
• It will produce vasoactive substances like GROWTH FACTORS, NITRIC OXIDE,
ENDOTHELIN and BRADYKININ
• These substances are potent VASOCONSTRICTOR and causes the INCREASE in
B.P
Role of kidney in Hypertension:
There are 3 mechanisms
1. RAS (Renin Angiotensin System)
•Renin is an enzyme produced by kidney that helps in formation of
ANGIOTENSIN-II
•ANGIOTENSIN-II increases the B.P via increasing
VASOCONSTRICTION as well as increases the BLOOD VOLUME
2. SODIUM RETENSION
2-renal factors plays an important role in sodium homeostasis
1. Glomerular filtration 2. GFR independent natriuretic factors

11. Cont….
When GFR falls, it turns to increased reabsorption of Na+
Increases BLOOD VOLUME
Increase in BLOOD PRESSURE
• When GFR natriuretic factors include atrial natriuretic factors
and factors of peptides secreted by heart atria in response to
volume expansion
Inhibits sodium reabsorption
Maintains the blood pressure

12. THANKS