PATHOPHYSIOLOGY OF HYPERTENSIVE CARDIOVASCULAR DISEASE

PREDISPOSING FACTORS ETIOLOGY PRECIPITATING FACTORS

Age: 73Y/O Unknown Sedentary lifestyle
History of Diet(fatty foods)
Hypertension BMI=30.5(Obese,
Grade I)

Increase intake of fats

Decrease blood flow Oxidative stress Fats clogs on arteries

to the arteries of the (arteriosclerosis)
heart
Disregulation in
Narrowing of blood
interaction between
Ischemia vessels (arteries)
MMP & inhibitors
(TIMPS)
ANGINA Increase vascular
Increase resistance
degredation of
A fibrilar collagen & Decrease blood flow to OLIGURIA
extracellular matrix organs (kidneys)

B
A
 A
B
Myocyte stretch (other humeral
A
Augmentation of stimuli such as angiotensin II,
degradation of Activation of RAAS phenylephrine/ endothelin)
normal cell type
collagen
Increased
contraction/pumping of Intracellular calcium
Fibrous deposits of the heart release
poorly cross linked
collagens
PALPITATION
Initiate transcription of genes
Myocyte fibrosis Aldosterone synthase gene
Calcium modulating gene
Increase blood
Decrease pumping action of the heart
pressure

C
HYPERTENSION Myocyte
hypertrophy
CARDIOMEGALY

Increase production Cardiac fibroblast

LEFT VENTRICULAR Proliferation of Myofibroblast
of fibronectin, undergo phenotypic
HYPERTROPHY fibroblast configuration
laminin, collagen I & II change
 C

Decrease blood flow

Atria beat very fast

Blood pools in the

atria

Ventricles beat very fast

Electrical signals
originate from Uncoordinated
around the atria beating of both
ventricles and atria

Signals travel
through the atria in Fast and irregular
a rapid & rhythm
disorganized
manner

Arrhythmia ATRIAL FIBRILLATION

Faulty signals flood
the AV node