Complications : Blood Pressure


  • 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 Odemand
        • 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.


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