Clinical epidemiology and consequences of having high blood pressure. Ivo Ricardo de Seabra Rodrigues Dias. What is hypertension?.
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Volume-loading HT – caused by excess accumulation of extracellular fluid in the body
HT caused by Primary Aldosteronism
caused by excess aldosterone or other types of steroids in the body; Primary Aldosteronism is a small tumor in one of the adrenal glands that causes the secretion of large quantities of aldosterone, which in turn increases the rate of salt and water reabsorption thereby increasing the extracellular fluid volume
When the artery to one kidney is constricted while the artery to the other kidney is normal, the constricted kidney retains salt and water because of decreased renal arterial pressure and the normal kidney retains salt and water because of renin produced by the ischemic kidney; both kidneys become salt and water retainers
HT caused by diseased kidneys that secrete renin chronically
Patchy areas of one or both kidneys are diseased and become ischemic because of local vascular constrictions; similar to two-kidney Goldblatt HT
Other types of HT caused by combinations of volume-loading and vasoconstriction
HT in the upper part of the body caused by coarctation of the aorta
When this occurs, blood flow to the lower body is carried by multiple small collateral arteries in the body wall, with much vascular resistance between the upper aorta and the lower aorta thus having an arterial pressure in the upper part of the body that is about 55% higher than that in the lower body
HT is one of the manifestations of the syndrome toxemia of pregnancy; it is believed there is a thickening of the kidney glomerular membranes, which reduces the rate of fluid filtration; to resume the normal filtration rate, the arterial pressure level must be increased
Acute HT can be caused by strong stimulation of the sympathetic nervous system (ex. stress, anxiety); when the sympathetic system becomes excessively stimulated, peripheral vasoconstriction occurs everywhere in the body