Hypertension Flashcards Preview

Cardiovascular > Hypertension > Flashcards

Flashcards in Hypertension Deck (40)
Loading flashcards...
1
Q

What is essential hypertension?

A

A rise in blood pressure of unknown cause that increases risk for cerebral, cardiac and renal events

2
Q

How is hypertension diagnonsed?

A

If the clinic BP is 140/90 mmHg or higher, offer ambulatory BP monitoring (ABPM) to confirm the diagnosis of hypertension

3
Q

What is ABPM?

A

At least two measurements per hour during the person’s waking hours

4
Q

What is stage 1 hypertension?

A

Clinic BP of 140/90 mmHg or higher AND ABPM daytime average of 135/85 mmHg

5
Q

What is stage 2 hypertension?

A

Clinic BP of 160/100 mmHg or higher AND ABPM daytime average of 150/95 mmHg

6
Q

What is severe hypertension?

A

Clinic BP of 180 mmHg or higher or clinic diastolic BP of 110 mmHg or nigher

7
Q

What tests should be offered to people with newly diagnosed hypertension to assess end organ damage?

A

Test urine for presence of proteinuria or raised levels of creatnine
Take blood to measure glucose, electrolytes, creatinine, estimated glomerular filtration rate and cholesterol
Examine fundi for hypertensive retinopathy
Arrange a 12-lead ECG

8
Q

What is an example of a risk calculator for CV disease?

A

Assign score

9
Q

What are examples of end organ damage due to chronic hypertension?

A

Left ventricular hypertrophy
Creatinine raised
Albuminuria/microalbuminuria
Retinopathy

10
Q

What are examples of established vascular disease?

A

Ischaemic heart disease
Cerbro-vascular disease
Peripheral vascular disease
Diabetes

11
Q

How do you assess for risk of CV disease?

A
Medical history 
FMH
Smoking 
CV exam (pulses bruits) 
Repeated BPs
Examine fundi
12
Q

What is the target blood pressure for those under 80?

A

140/90 mmHg

13
Q

What is the target blood pressure for those ages 80 and over?

A

150/90 mmHg

14
Q

What contributes to hypertension?

A
High triglycerides
High cholesterol
High heart rate
High BMI
High Haematocrit
15
Q

What does a 5mmHg reduction in BP do to your risk of stroke?

A

Decreases the chance of stroke by 40%

16
Q

What are common causes of secondary hypertension?

A

Renal disease
Obstructive sleep apnoea
Aldosteronism
Reno-vascular disease

17
Q

What are uncommon causes of secondary hypertension?

A
Cushing's 
Pheochyomocytoma
Hyperparathyrodism 
Aortic coarctation 
Intercranial tumour
18
Q

What is a pheochyomocytoma?

A

Pheochromocytoma is a rare tumor of adrenal gland tissue. It results in the release of too much adrenaline and noradrenaline, hormones that control heart rate, metabolism, and blood pressure.

19
Q

How can renal artery stenosis be treated?

A

Via angioplasty and stent

20
Q

What is fibromuscular dysplasia?

A

Fibromuscular dysplasia (FMD) is a non-atherosclerotic, non-inflammatory disease of the blood vessels that causes abnormal growth within the wall of an artery.

21
Q

Where can fibromuscular dysplasia be found?

A

FMD has been found in nearly every arterial bed in the body although the most common arteries affected are the renal and carotid arteries

22
Q

Who does fibromuscular dysplasia affect?

A

Young women

23
Q

What lifestyle advice should you give people about hypertension?

A
Diet (reduce sodium intake)
Weight reduction 
Exercise 
Alcohol consumption 
Smoking
24
Q

What patient education can be given regarding hypertension?

A

Info about benefits of drugs and side effects
Details or patient organisations
An annual review of care

25
Q

What weight loss is recommened for reducing hypertension?

A

1mmHg for every kg

26
Q

What decrease in alcohol consumption is recommended for reducing hypertension?

A

Alcohol reduction should be recommended for the prevention and treatment of hypertension among heavy drinkers

27
Q

What exercise is recommended for reducing hypertension?

A

15min/day produces a 14% reduced mortality

28
Q

What effect does a no salt added diet have to hypertension?

A

Reduces BP 2-4 mmHg

29
Q

What are the generic antihypertensives?

A
Thiazide dieuretics
ACE inhibitors
ARBs
Calcium channel blockers 
Beta blockers
Spironolactone 
Alpha blockers
30
Q

What drugs are used in combo for hypertension and angina?

A

Beta blockers or calcium channel blockers

31
Q

What drugs are used in combo for hypertension and CCF?

A

ACE inhibitors and beta blockers

32
Q

What drugs are used in combo for hypertension and diabetic nephropathy?

A

ACEI/ARBs

33
Q

What drugs are used in combo for hypertension and prostatism?

A

Alpha blockers

34
Q

What drugs are preferred in treating the elderly for hypertension?

A

Thiazides

35
Q

What is the guidelines for anti hypertensive drug treatment for patients under 55?

A
Step 1= ACEI/ARBs
Step 2 = Add CCB
Step 3 = Add thiazide-like diuretic 
Step 4 (resistant hypertension) = Add further diuretic or alpha/beta blocker
36
Q

What are the guidelines for anti hypertensive drug treatment for patients over 55 or black person of African or Carribbean family origin of any age?

A

Step 1 = CCB
Step 2 = Add ACE/ARBs
Step 3 = Add diuretic
Step 4 = Consider further diuretic or alpha/beta blocker

37
Q

Should you add another drug to treatment or titrate higher doses?

A

Adding a drug is 5x more effective than titrating

38
Q

What are causes of resistant hypertension?

A
Non-concordance (not taking the drugs) 
White coat effect
Pseudo-hypertension 
Lifestyle factors 
Drug interactions 
Secondary hypertension 
True resistance
39
Q

What is the most effective drug in the treatment of hypertension?

A

Spironolactone - start low and go slow
Caution with diabetes and low GFR (glomerular filtration rate)
Tolerate a 25% rise in K+ and creatinine

40
Q

What are the new technologies to treat hypertension?

A

Renal denervation
Baro-receptor stimulation
Rox Coupler