(精编)【高血压英文教学精品课件】 Pathology of blood and lymphatic vessels.pptVIP

Diseases of arterias B. Atherosclerosis Pathogenesis of atherosclerosis ? The contemporary view of the pathogenesis: Atherosclerosis is a chronic inflammatory response of arterial wall initiated by some form of endothelial injury!! ? Continuation: g) release of factors from activated platelets, macrophages or vascular cells, h) migration of smooth muscle cells from media into intima, i) proliferation of smooth muscle cells in the intima and elaboration of extracellular matrix, j) accumulation of collagen anf proteoglycans, k) enhanced accumulation of lipids within macrophages, smooth muscle cells and extracellularly. Diseases of arterias C. Hypertensive Vascular Disease One of the most important risk factors in both coronary heart disease and cerebrovascular accidents. It may also lead to cardiac hypertrophy with heart failure, aortic dissectin, and renal failure. About 90-95% of hypertension is idiopathic and apparenly primary – essential hypertension. Of the remaining, 5-10% is secondary to renal disease or, less often, to narrowing of the renal artery (usually by an atheromatous plaque) – renovascular hypertension. Infrequently, secondary hypertension is the result of diseases related to the adrenal gland (such as primary aldosteronism, Cushing syndrome, pheochromocytoma etc.). About 5% of hypertensive persons show a rapidly rising blood pressure, which, if untreated, leads to death within 1 or 2 years – malignant hypertension. Diseases of arterias C. Hypertensive Vascular Disease Morphology Hypertension accelerates atherogenesis and causes changes in the structure of the wall of blood vessels that potentiate both aortic dissection and cerebrovascular hemorrhage. In addition, hypertension is associated with 2 forms of small blood vessel disease – hyaline arteriolosclerosis (in elderly patients, more severe in patients with hypertesion and diabetes, a homogenous, pink, hyaline thickening of the walls of arterioles with narrowing of the lume