Difference between revisions of "Hypertension"
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'''Hypertension''' is very common and affects multiple organs. Clinically, it is usually classified as primary (idiopathic) and secondary. | '''Hypertension''' is very common and affects multiple organs. Clinically, it is usually classified as primary (idiopathic) and secondary. | ||
Hypertensive crisis, if untreated, is associated with damage to the brain, heart, eye and kidneys.<ref name=pmid19899722>{{cite journal |author=Janota T |title=[Hypertensive crisis--the present view] |language=Czech |journal=Cas. Lek. Cesk. |volume=148 |issue=8 |pages=370–3 |year=2009 |pmid=19899722 |doi= |url=}}</ref> | Hypertensive crisis, if untreated, is associated with damage to the brain, heart, eye and kidneys.<ref name=pmid19899722>{{cite journal |author=Janota T |title=[Hypertensive crisis--the present view] |language=Czech |journal=Cas. Lek. Cesk. |volume=148 |issue=8 |pages=370–3 |year=2009 |pmid=19899722 |doi= |url=}}</ref> | ||
Pulmonary hypertension is dealt with separately in the article ''[[pulmonary hypertension]]''. | |||
==Brain== | ==Brain== | ||
===Charcôt-Bouchard aneurysms=== | ===Charcôt-Bouchard aneurysms=== | ||
====General==== | ====General==== | ||
*[[AKA]] miliary aneurysms. | *[[AKA]] ''miliary aneurysms'' and ''microaneurysm''.<ref name=pmid17416106>{{cite journal |author=Kojima H, Eguchi H, Mizutani T, Tanaka K, Kikuchi Y, Fukudome N |title=Three-dimensional analysis of pathological characteristics of a microaneurysm |journal=Clin. Neuropathol. |volume=26 |issue=2 |pages=74–9 |year=2007 |pmid=17416106 |doi= |url=}}</ref> | ||
*[[Intracerebral hemorrhage]]s. | *Associated with [[Intracerebral hemorrhage]]s. | ||
*Classically found in the basal ganglia or the pons.<ref>URL: [http://missinglink.ucsf.edu/lm/introductionneuropathology/Response%20_to_Injury/Microvascular.html http://missinglink.ucsf.edu/lm/introductionneuropathology/Response%20_to_Injury/Microvascular.html]. Accessed on: 24 September 2010.</ref> | |||
====Microscopic==== | ====Microscopic==== | ||
Revision as of 19:17, 24 September 2010
Hypertension is very common and affects multiple organs. Clinically, it is usually classified as primary (idiopathic) and secondary.
Hypertensive crisis, if untreated, is associated with damage to the brain, heart, eye and kidneys.[1]
Pulmonary hypertension is dealt with separately in the article pulmonary hypertension.
Brain
Charcôt-Bouchard aneurysms
General
- AKA miliary aneurysms and microaneurysm.[2]
- Associated with Intracerebral hemorrhages.
- Classically found in the basal ganglia or the pons.[3]
Microscopic
Features:[4]
- Small aneurysms (~300 micrometers) with a fusiform shape.
- Vessel wall changes:
- Early:
- Proliferation of arteriolar smooth muscle
- Late:
- Apoptotic smooth muscle cell death and collagen deposition.
- Early:
Image: C-B aneurysm (ucsf.edu).
Hypertension and the eye[5]
- Hypertensive retinopathy.
- Aneurysms.
- Branch retinal vein occlusion (BRVO).
- Vitreous hemorrhage.
Hypertensive heart disease
General
- Treated with antihypertensives.
- Mechanism of death: (ventricular) arrhythmia.[6]
Associated pathology[6]
- Left atrial enlargement and atrial fibrillation.
Gross
Features:[7]
- Left ventricular hypertrophy (concentric).
Notes:
- In the autopsy context, significant valvular heart disease should be absent.
Microscopic
Features:[7]
- Arteriolosclerosis of intramural coronary arteries and arterioles.
- Fibrosis of media.
- Peirarteriolar fibrosis.
Kidney
General
- May result in renal failure.
Microscopic
Features:[8]
- Fibrinoid necrosis of afferent and interlobular arteries (due to endothelial cell damage).
See also
References
- ↑ Janota T (2009). "[Hypertensive crisis--the present view]" (in Czech). Cas. Lek. Cesk. 148 (8): 370–3. PMID 19899722.
- ↑ Kojima H, Eguchi H, Mizutani T, Tanaka K, Kikuchi Y, Fukudome N (2007). "Three-dimensional analysis of pathological characteristics of a microaneurysm". Clin. Neuropathol. 26 (2): 74–9. PMID 17416106.
- ↑ URL: http://missinglink.ucsf.edu/lm/introductionneuropathology/Response%20_to_Injury/Microvascular.html. Accessed on: 24 September 2010.
- ↑ Auer RN, Sutherland GR (December 2005). "Primary intracerebral hemorrhage: pathophysiology". Can J Neurol Sci 32 Suppl 2: S3–12. PMID 16450803.
- ↑ URL: http://health.indiamart.com/eye-care/hypertension-and-eye.html. Accessed on: 23 September 2010.
- ↑ 6.0 6.1 Prisant LM (April 2005). "Hypertensive heart disease". J Clin Hypertens (Greenwich) 7 (4): 231–8. PMID 15860963.
- ↑ 7.0 7.1 Schwartzkopff B, Strauer BE (2000). "Coronary reserve and arteriolosclerosis in hypertensive heart disease". Z Kardiol 89 Suppl 9: IX/132–5. PMID 11151783.
- ↑ Ono H, Ono Y (November 1997). "Nephrosclerosis and hypertension". Med. Clin. North Am. 81 (6): 1273–88. PMID 9356598.