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Year 3 Medicine > Cardio - HTN > Flashcards

Flashcards in Cardio - HTN Deck (10)
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1
Q

What is stage 1 hypertension? What important factors must you consider in your treatment?

A

Clinic BP>= 140/90 mmHg and subsequent ABPM daytime average or HBPM average BP >= 135/85 mmHg

-Treat if <80 ya of age AND any of following apply: target organ damage, established CVS disease, renal disease, diabetes or 10-year CVS risk equivalent to 20% or greater

2
Q

What is stage 2 hypertension? What factors must you consider when thinking of treatment?

A
  • Clinic BP >= 160/100 and subsequent ABPM daytime average of HBPM average BP >= 150/95
  • Offer Rx regardless of age
3
Q

What is severe (stage 3) hypertension?

A

-Clinic systolic >=180 mmHg or clinic diastolic >= 110 mmHg

4
Q

What must you do for pts <40 ho have HTN?

A

-Refer to specialist to look for 2ndary causes

5
Q

What are the clinic BP and ABPM targets for patients below and above 80 years old

A
  • Age <80: 140/90 mmHg (clinic) and 135/85 mmHg (home/ambulatory)
  • Age >80: 150/90 mmHg and 145/85 mmHg (home/ambulatory)
6
Q

What lifestyle advice should you give to manage HTN?

A
  • Low salt diet (aim <6g/day, ideal 3G/day)
  • Reduce caffeine intake
  • General advice: stop smoking, drink less alcohol, balanced diet, exercise more, lose weight
7
Q

HTN Mx: step 1

A
  • Patients <55 years old: ACE inhibitor - ramipril

- Patients >=55 years old or Afro-Caribbean: CCB (or ARB if cannot tolerate)

8
Q

HTN Mx: step 2

A

-ACE I + CCB

9
Q

HTN Mx: step 3

A
  • ACEe + CCB
  • Add thiazides diuretic: eg bendroflumethiazide
  • *NICE now advocate using thiazides like diuretic: chlorthalidone (12.5-25mg OD) or indapamide (1.5mg modified release OD or 2.5mg OD) in preference to congenital thiazide diuretic
10
Q

HTN Mx: step 4

  • At what stage do you consider pt to have resistant HTN?
  • What is step 4?
A
  • Clinic BP >= 140/90 mmHg after step 3 = resistant HTN
  • Need to escalate to step 4 or seek expert advice

Step 4
-Further diuretic Rx:
K+<4.5 mmol/L add spironolactone 25mg OD
K+>4.5 mmo/L add higher-dose thiazide-like diuretic rx
-IF further diuretic rx not tolerated/CI/ineffective - consider alpha blocker or beta blocker

Decks in Year 3 Medicine Class (41):