Etiology of Hypertension Genetic factors play an important role. Children with one- or two-hypertensive parents have higher blood pressures. Environmental factors also are significant Increased salt intake has long been incriminated as a pathogenic factor in essential hypertension. It alone is probably not sufficient to elevate blood pressure to abnormal levels; a combination of too much salt plus a genetic predisposition is required
16 Etiology of Hypertension ◼ Genetic factors play an important role. Children with one- or two-hypertensive parents have higher blood pressures. ◼ Environmental factors also are significant. Increased salt intake has long been incriminated as a pathogenic factor in essential hypertension. It alone is probably not sufficient to elevate blood pressure to abnormal levels; a combination of too much salt plus a genetic predisposition is required
Etiology Determinates of hypertension GRA A Angiotensin Diabetes Major genes Kallikrein Na-Li counter. Obesity Polyge nes transport? Race Haptoglobin Blood pressure Mn blood type Major gene traits: RBC Na Background Na-K cotransport? Combination FDH? FCHL? Nonmodulation? Environment Individual ↑ Sympathetics Shared Others? Diet Oral contraceptives Na Physical inactivity K Fat Stress CI Calories Lower education Ca Alcohol Small family size Me Caffein e current Medicine 17
17 Etiology
Environment Heredity Dysfunctional iol transporters Diet Insulin resistance Stress Undetermined gene Hemodynamic Altered arterial wall alterations cell function Adaptive changes in structure and function Dysfunctional endothelium Proliferative smooth muscle Increased peripheral vascular resistance and hypertension Current Medicine 18
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Question How about the pathogenesis in hypertension is? 19
19 Question: ◼ How about the pathogenesis in hypertension is ?
Pathogenesis The pathogenesis of essential hypertension is multifactorial Sympathetic nervous system yperactivity. It is most apparent in younger hypertensives, who may exhibit tachycardia and an elevated cardiac output. However, correlations between plasma catecholamines and blood pressure are poor
20 Pathogenesis ◼ The pathogenesis of essential hypertension is multifactorial. ◼ Sympathetic nervous system hyperactivity. It is most apparent in younger hypertensives, who may exhibit tachycardia and an elevated cardiac output. However, correlations between plasma catecholamines and blood pressure are poor