11Predisposing Factors:Genetics, Age, Gender, Race

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

Chronic Inflammation

Over-activity of SNS RAAS Dysfunction

↑Heart Rate↑Vascular Resistance

↑Sodium and Water Retention

↑ Angiotensin ↑Insulin resistance

↑Glucose

Vascular changes

Atherosclerosis

↑Blood Volume

↑production of catecholamine(Epinephrine & Norepinephrine)

Hypertension

↑ Renin

↑Peripheral Vascular Resistance

Tissue Ischemia

End Organ Dysfunction

↑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