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Precipitating Factors:Stress, Obesity, Nutrients, Substance abuse, DM, Kidney Disorder

Chronic Inflammation

StimulationOver-activity of SNS

RAAS Dysfunction

Predisposing Factors:Genetics, Age, Gender, Race

↑Heart Rate↑Vascular Resistance

↑Insulin resistance

↑Glucose

Vascular changes

Atherosclerosis

Tissue Ischemia

End Organ Dysfunction

↑Sodium and Water Retention

↑ A

↑Blood Volume

↑production of catecholamine

↑ Renin

↑Peripheral Vascular Resistance

Increased Blood Glucose level

Damage in Blood vessels and arteries

Inc. risk of having Atherosclerosis

Activation of Raas

Kidney produces renin

Renin catalyzes angiotensinogen and converts to angiotensin 1

Angiotensin 1 converted to Angiotensin 2 in the lungs

Angiotensin 2 stimulates adrenal cortex

Adrenal cortex release aldosterone

Sodium reabsorption

Decreased size of lumen of arteries and veins

Angiotensin 2 increases ADH secretion

Water retention

Hypertension

↑Peripheral Vascular Resistance

↑Sodium and Water Retention

↑ Angiotensin II

Hypertrophy of myocardium associated

to hypertension

Vascular remodelling

Weak blood vessels

Endothelial dysfunction

Platelet aggregation

↑endomethelin(vasoconstrictor)↓nitric oxcide

(vasodilator)

Atherosclerosis

Smooth muscle contraction

Tissue Ischemia

Anaerobic metabolism

Lactic Acid fomation

Pain

Arterial vessels of lower extremities

Heart Kidney Brain Eyes

Head ache, dizziness, fatigue, changes in mentation, sensorium and neurologic status

Blurring of vision, double vision, and other visual anomalies

Chest pain ↓Urine output Claudication, painful sensation,

Mayocardial ischemia, MI

Chronic Kidney Disease

Retinal Vascular sclerosis, Loss of

Vision

Gangrene

Death

Stroke, Transient ischemic attack,

Acute brain infarction, Cerebral

thrombosis, aneurysm