Ateriosclerosis and Hypertension
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what is ateriosclerosis?
hardening of the arteries
characterized by the atheroma, involves large and medium arteries
define monckeberg's medial calcific sclerosis
medial calcification without luminal narrowing or intimal disruption
- two types
- 1. hyaline: thickening of BM, assoc. w/ hypertension and diabetes mellitus
- 2. hyperplastic: fibrocellular intimal thickening, assoc. w/ malignant hypertension and scleroderma
define fibroelastic hyperplasia
proliferative arteriosclerosis: concentric smooth muscle cell proliferation and collagen deposition of the intima of small and medium-sized muscular arteries.
list 4 types of ateriosclerosis
- 1. atherosclerosis
- 2. monckeberg's medial calcific sclerosis
- 3. arteriolosclerosis
- 4. fibroelastic hyperplasia
list 5 modifiable risk factors associated with arteriosclerosis
- 1. cigarette smoking (pack a day increases death rate by 200%)
- 2. diabetes mellitus
- 3. hypertension
- 4. hypercholesterolemia (HDL inversely assoc. w/ atherosclerosis)
- 5. C-reactive protein
list 7 soft/uncertain risk factors of arteriosclerosis
- 1. lack of exercise
- 2. obesity
- 3. type A personality (stress)
- 4. high carb intake
- 5. lipoprotein
- 6. chlamydia pneumonia infection
- 7. hyperhomocysteinemia
list 6 common sites of atheroma formation
- 1. major arterial branch points
- 2. abdominal aorta
- 3. coronary arteries
- 4. popliteal arteries
- 5. carotid arteries
- 6. cerebral arteries
list the main components of atheroma plaques
plaques contain collagen, lipid, myofibroblasts, macrophages, and neovascularization
describe fibrous cap
composed of smooth muscle and collagen. develops over a central core of lipids and cholesterol
what are 5 progressive changes in plaque?
- 1. ulceration
- 2. fissure formation
- 3. thrombosis
- 4. embolization
- 5. calcification
describe fatty streak
term given to earliest stages of atheromas. can occur in infants and children in geographically prone areas. characterized by lipid-laden cells in the intima.
list 5 complications of atherosclerosis
- 1. IHD
- 2. stroke
- 3. gangrene
- 4. nephrosclerosis
- 5. aneurysm
list the 3 ranges of hypertension for diagnosing hypertension
- Normal: BP < 140/90
- Mild: 140/90 - 159/104
- Moderate/Severe: BP > 160/106
what are some symptoms of hypertension?
most show no symptoms until organ damage has occured
what complications can high BP cause?
headaches, fatigue, dizziness, palpitations
list 4 pathologies of hypertension
- 1. left ventricular hypertrophy (compensated)
- 2. LV hypertrophy + dilation and CHF (decompensated)
- 3. atherosclerosis leads to IHD, stroke, and ischemic injury in other organs
- 4. arteriosclerosis leads to retinal injury and kidney damage/nephrosclerosis (renal failure)
list 2 pathogenesises of hypertension
- 1. peripheral vascular resistence (vasoconstriction)
- 2. reduced sodium excretion-->salt/water retention-->increased plasma volume and cardiac output
define secondary hypertension
hypertension caused by other diseases. the hypertension is under control when the disease is controlled.
define the response-to-injury hypothesis
a hypothesis explaining atherogenesis as initiating with some injury to the endothelial cells lining the artery walls, which causes endothelial dysfunction and leads to abnormal cellular interactions and initiation and progression of atherogenesis.
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