HTN Pathophysiology Lecture Fall (4) (1)

Estrogens sodium retention corticosteroids increased

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Estrogens Sodium retention Corticosteroids Increased fluid retention Prednisone Cyclosporine Sodium and water retention, increased PVR Triptans Increased PVR Sumatriptan
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Medications Abruptly discontinuing medications Beta blockers Centrally acting alpha agonists Withdrawal Nicotine Narcotic Cocaine
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Renal Disease Renovascular disease Atherosclerotic disease of renal blood vessels Reduced renal blood flow RAAS activation Renal parenchymal disease Chronic glomerular nephritis Polycyctic kidney disease Nephrosclerosis Diabetic nephropathy Chronic pyelonephritis
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Endocrine Thyroid disorders Hyperthyroid Primary hyperparathyroidism Increased Ca++ Pheochromocytoma Paroxysms of hypertension accompanied by headache, palpitations, pallor, and perspiration Hyperaldosteronism Unprovoked hypokalemia Cushing’s disease Truncal obesity, glucose intolerance, and purple striae
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Other Secondary Causes Sleep apnea Snoring Daytime somnolence Interrupted sleep patterns Nightmares Sodium intake Is the patient complaint with sodium restriction diet? EtOH Greater than or equal to 3 drinks per day Systolic BP more affected than diastolic BP
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Other Types of Hypertension Office or “White Coat Hypertension” BP values when measured in a clinical environment Typically < 135/85 at home Hypertensive crises: BP > 180/120 Hypertensive urgency: no TOD Hypertensive emergency: with TOD
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Questions???
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