0805 - hypertension - AHF Flashcards

1
Q

How many Australians are diagnosed with hypertension?

A

1 in 3; it is the most frequently managed chronic problem in general practice; it is predominantly asymptomatic.

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2
Q

Outline some valuable resources for cardiology.

A
  • www.heartfoundation.org.au - cardiac society of Australia and New Zealand (www.csanz.org.au) - FASEB journal (Federation of American society for experimental biology)
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3
Q

Define white-coat hypertension.

A

Px exhibits elevated blood pressure in clinical setting.

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4
Q

Define masked hypertension.

A

Px exhibits elevated blood pressure in daily living, but reduced BP in clinical setting.

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5
Q

Sub-optimal BP (systolic > 115 mmHg) accounts for what percentage of the global burden of disease?

A

4.4%

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6
Q

Explain the link between hypertension and the progression of CVD.

A
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7
Q

What is the device used to measure BP?

A

Sphygmomanometer.

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8
Q

Define blood pressure.

A

Pressure exerted by circulating blood upon the walls of blood vessels; refers to systemic circulation (usually the arteries) unless otherwise specified; aka MAP.

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9
Q

What determines BP (MAP)?

A

MAP = CO * TPR MAP = HR * SV * TPR (CO around 5 L/min at rest)

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10
Q

Define vascular resistance.

A

The resistance to flow that must be overcome to push flood through the circulatory system.

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11
Q

What is important in the diagnosis of hypertension?

A

The diagnosis must be based upon multiple readings.

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12
Q

Outline the diagnostic categories of blood pressure in adults.

A
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13
Q

What is the most common cause of hypertension.

A

Idiopathic (lifestyle, genetic).

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14
Q

Why should we assess all patients with hypertension?

A
  • to identify all CVD risk factors - to calculate absolute risk - to detect end-organ damage (e.g. heart, kidneys) - to detect co-morbid conditions - to identify causes of secondary hypertension
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15
Q

Define absolute risk.

A

The numerical probability of a cardiovascular event occurring within a five-year period. It reflects a person’s overall risk of developing CVD replacing the traditional method that considers various risk factors, such as high cholesterol or high blood pressure, in isolation.

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16
Q

How does absolute risk affect the treatment of hypertension?

A

“Not just looking at the BP number, but the company it keeps.” Px with: - high absolute risk: treat as CHD equivalent; do not wait for the disease to develop - intermediate absolute risk: may require intensive treatment; more information required - low absolute risk: intensive treatment not required

17
Q

Outline the groups at high absolute cardiovascular risk

A

Group A: patients aged 75 years and old Group B: patients with existing CVD Group C: patients with associated clinical conditions and/or end-organ disease

18
Q

Why should we intervene for a Px with hypertension?

A
  • reduce BP - reduce absolute cardiovascular risk - minimise end-organ damage
19
Q

When should we initiate drug treatment for a Px with hypertension?

A
  • grade 3 hypertension - isolated systolic hypertension with widened pulse pressure - systolic ≥ 160 mmHg and diastolic ≤ 70 mmHg - associated conditions or target-organ damage
20
Q

What are the two avenues of hypertension management?

A
  • lifestyle modification - pharmacologic therapy o low does thiazide diuretic o beta-blocker o ACE inhibitor o calcium channel blocker
21
Q

What are the BP targets for: a. adults ≥ 65 years old (unless diabetes and/or renal insufficiency and/or proteinuria ≥ 0.25 g/day) b. adults 1 g/day (with or without diabetes

A

a.

22
Q

Why may BP be resistant to treatment?

A
  • non-compliance - undiagnosed secondary hypertension - hypertensive effects of other drugs - treatment resistance due to sleep apnoea - undisclosed use of alcohol or recreational drugs - unrecognised high salt intake - volume overload, especially with chronic kidney disease - technical factors affecting measurement - white-coat hypertension