Pathophysiology of the person’s key condition – Hypertension & associated atherosclerosis

• Pt has many risk factors for hypertension including being male (higher risk), family history of hypertension on fathers side, environmental stressors (jail activation of SNS fight or flight response), lack of physical activity due to arthritis use of wheelchair.

• Blood pressure is the lateral force on the walls of an artery as blood is pumped out by the heart

• Blood pressure is determined by cardiac output, blood viscosity and presence of total peripheral resistance.

• In this case study his previously uncontrolled hypertension in the community combined with risk factors such as family history, smoking, poor diet and aging has led to vascular damage and arterial remodelling through permanent damage of the tunica intima & media layers of his arteries from prolonged increased workload of the heart.

• The damage of the inner layer of the arteries at this level can attract plaque to form which is where atherosclerosis formation begins, overtime eventually hardening and causing a narrowing of arteries which increases blood pressure and risk for rupture of that plaque

• Rupture of this plaque can result in platelet formation and thrombosis at the plaque site which combined with increased arterial pressure can cause it to break off and form an embolism which can cause myocardial infarction if circulated to the heart (which he has suffered from previously) or a stroke if it is circulated to the brain.