A client with a diagnosis of chronic renal failure secondary to diabetes has seen a gradual increase in her blood pressure over the past several months, culminating in a diagnosis of secondary hypertension

Question

Which of the following has most likely resulted in the client's increased blood pressure?
A) Increased levels of adrenocortical hormones
B) Activation of the renin–angiotensin–aldosterone mechanism
C) Increased sympathetic stimulation by the autonomic nervous system (ANS)
D) Coarctation of the client's aorta

Answer 1

Ans: B
Feedback:
Renovascular hypertension refers to hypertension caused by reduced renal blood flow and activation of the renin–angiotensin–aldosterone mechanism. It is the most common cause of secondary hypertension, accounting for 1% to 2% of all cases of hypertension. The reduced renal blood flow that occurs with renovascular disease causes the affected kidney to release excessive amounts of renin, increasing circulating levels of angiotensin II. Angiotensin II, in turn, acts as a vasoconstrictor to increase peripheral vascular resistance and as a stimulus for increased aldosterone levels and sodium retention by the kidney. One or both of the kidneys may be affected. A renal etiology is not associated with secondary hypertension due to hormonal factors, sympathetic stimulation, or coarctation of the aorta.