Flashcards in Hypertension Deck (23)
What percentage of people with hypertension have essential/idiopathic hypertension?
Name 4 factors that would predispose an individual to developing hypertension
Sympathetic stimulation, genetics, activation of RAAS, endothelial dysfunction (less NO released), smoking, drinking, obesity, low birth weight
What percentage of the adult population have essential hypertension?
Which ethnic group suffer hypertension more commonly?
What sensory organ is often affected by hypertension?
Eyes (hypertensive retinopathy)
What is grade 1 hypertensive retinopathy?
Increased vessel tortuosity and silver wiring
What is the second stage of hypertensive retinopathy?
Grade 1 with arteriovenous nipping where thickened arteries cross over veins
What is grade 3 hypertensive retinopathy?
As grade 2 but with soft cotton wool exudates and flame shaped haemorrhages
What is grade 4 hypertensive retinopathy?
Grade 3 with pappiloedema
What might urinalysis show?
Proteinuria, heamaturea due to renal damage
What other investigation might you want to do?
Urea and creatinine levels, CXR (cardiomegaly), ECG and echo
Treatment is aimed at keeping BP to what?
If diabetic what is the BP aim?
What are the three first line anti hypertensives?
ACEIs, CCBs, thiazide diuretics
What drugs may be added I'd all three first line drugs are being used?
Alpha blockers, beta blockers, loop diuretic
What is malignant hypertension?
A diastolic of over 130
What does malignant hypertension cause?
Acute vascular damage and encepahlopathy
What percentage of secondary hypertensives have a renal cause?
Name 5 causes of secondary hypertension?
Renal artery stenosis, chronic glomerulonephritis, chronic pyelonephritis, poly cystic kidney disease, phaechromacytoma, conn's syndrome (hyper aldosteronism), coarctation of the aorta, pregnancy, oral contraceptive, steroids, ciclasporin
When should you suspect secondary especially?
In young patients under 40
What investigations would you do for secondary?
U and Es, urinalysis, cortisol, growth hormone, urinary catecholamines, CXR, MRI
Difference between secondary and essential management?
Treat the cause but otherwise the same