Complications : Blood Pressure

Complications

• Target organ diseases occur most frequently in
  • Heart
    • Hypertensive heart disease
      • Coronary Artery disease
        • Hypertension disrupts the coronary artery endothelium
        • This results in a stiff arterial wall with a narrowed lumen, and accounts for a high rate of CAD, angina, and MI.
      • Left ventricular hypertrophy
        • Increased contractility increases myocardial work and O₂ demand
      • Heart failure
        • Occurs when the heart’s compensatory mechanisms are overwhelmed and the heart can no longer pump enough blood to meet the body’s demands
  • Brain
  • • • Cerebrovascular disease
        • When BP exceeds the body’s ability to autoregulate, the cerebral vessels suddenly dilate, capillary permeability increases, and cerebral edema develops.
        • This produces a rise in intracranial pressure. If left untreated, patients can die quickly from brain damage
    • Peripheral vascular disease
      • Hypertension speeds up the process of atherosclerosis in the peripheral blood vessels.
      • This leads to the development of peripheral vascular disease, aortic aneurysm, and aortic dissection
    • Kidney
      • Nephrosclerosis
        • Results from ischemia caused by the narrowing of the renal blood vessels.
        • This leads to atrophy of the tubules, destruction of the glomeruli, and eventual death of nephrons.
        • Initially intact nephrons can compensate, but these changes may eventually lead to renal failure
        • Laboratory indications of renal disease are albuminuria, proteinuria, microscopic hematuria, and elevated serum creatinine and blood urea nitrogen (BUN) levels.
    • Eyes
      • Retinal damage
        • Damage to the retinal vessels provides an indication of related vessel damage in the heart, brain, and kidneys.
        • Manifestations of severe retinal damage include blurring of vision, retinal hemorrhage, and loss of vision.