PATHOPHYSIOLOGY OF HYPERTENSION

Vascular resistance is a term used to define the resistance to flow that must be
overcome to push blood through the circulatory system. The resistance offered
by the peripheral circulation is known as the systemic vascular resistance (SVR)
Afterload is the tension or stress developed in the wall of the ventricle during
ejection.
Juxtaglomerular cells (JG cells, or granular cells) are cells in the kidney that
synthesize, store, and secrete the enzyme renin.
Renin also known as an angiotensinogenase, is an enzyme that participates in
the body's renin-angiotensin system (RAS)also known as the reninangiotensin-aldosterone axisthat mediates extracellular volume (i.e., that of
the blood plasma, lymph and interstitial fluid), and arterial vasoconstriction. Thus,
it regulates the body's mean arterial blood pressure.
Renal perfusion
The rate of perfusion in the kidney is much higher than in any other organ. The
rate of formation of urine depends to a large extent on the perfusion rate.
Hyponatremia
Is an electrolyte disturbance in which the sodium ion concentration in the
plasma is lower than normal.
Angiotensinogen
A serum 2-globulin secreted in the liver which, on hydrolysis by renin, gives rise
to angiotensin.
Beta-receptor - a site in the autonomic nervous system in which inhibitory
responses occur when adrenergic agents, such as norepinephrine and
epinephrine, are released. Activation of beta-receptors causes various
physiological reactions, such as relaxation of the bronchial muscles and an
increase in the rate and force of cardiac contraction.
Hypovolemia - a blood disorder consisting of a decrease in the volume of
circulating blood
Angiotensin I - a physiologically inactive form of angiotensin that is the
precursor to angiotensin II
Angiotensin II - a potent vasopressor agent formed from angiotensin I

Angiotensin- converting enzyme

ACE, angiotensin I and angiotensin II are part of the renin-angiotensin system
(RAS), which controls blood pressure by regulating the volume of fluids in the
body. ACE is secreted in the lungs and kidneys by cells in the inner layer of blood
vessels.

Arteriolar vasoconstriction
Arterioles are the smallest vessels of the arterial system, with a diameter of about
1/3 millimeter or smaller. There is much smooth muscle in their tunica media,
which causes vasocontriction when it contracts, and vasodilation when it
relaxes. Such vasoconstriction and vasodilation plays two important roles in the
cardiovascular system.

Controls of distribution of blood flow to different parts of the body

Determines the total peripheral resistance

Peripheral resistance
Resistance to the passage of blood through the small blood vessels, especially
the arterioles.
Adrenal Cortex
mediates
the
stress
response
through
the
production
of mineralocorticoids and glucocorticoids,
including aldosterone and cortisol respectively. It is also a secondary site
of androgen synthesis.
Aldosterone A steroid hormone secreted by the adrenal cortex that regulates the
salt and water balance in the body.
Blood pressure
1. The pressure of blood against the walls of any blood vessel.
2. The pressure of blood on the walls of the arteries, dependent on the energy of
the heart action, elasticity of the arterial walls, and volume and viscosity of the
blood; the maximum or systolic pressure occurs near the end of the stroke output
of the left ventricle, and the minimum or diastolic late in ventricular diastole.