3 8. Childhood systemic hypertension. Flashcards
What is the etiology of primary / essential hypertension
Multi factorial- genetic and environmental diseases
Risk factors Family history Ethinicity Obesity Type 1 diabetes Diet high in sodium Alteration in RAAs system
Definition of systemic hypertension ?
Normal pressure
Below the 90th percentile
Less than 120/80
Elevated blood pressure
Below 95th percentile
<129/80
Hypertension stage 1
Defined as arterial pressure over the 95th percentile for age , height and gender
<139/89
Stage 2
Is over the 95th percentile + 12mmhg
140/90 or more
Do you know the symptoms of essential hypertension
Usually asymptomatic until end organ stage
Headache , end stage disease
Most predominant organs it effects - left ventricular hypertrophy
How do you diagnose hypertension
Blood pressure monitoring minimum two readings
Treatment approach for systemic hypertension
Lifestyle - diet rich in fruit and veg Less salt More exercise Reduce weight Increasing dietary potassium
Acei inhibitors
Dry cough
Angioedema
Hyperkalemia
Captopril / enalopril -1-2mg/kg/ day
Arbs
Losartan
Hyperkalemia
Thiazides diuretics
Hydrochlorothiazide
Increase glucose and cholesterol , hypokalemia
CCB Dihydropridines Nifedipine Amlodipine Gingival hyperplasia / pedal edema
Non DHP
Diltiazem
Verapamil
Bradycardia and AV block
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Beta blockers Propranolol Meta prolol Bronchoconstriction Triglycerides
Loop
Alesterone antagonists
Direct renin inhibitors
Not used in combo with Ace
Aliskiren
Alpha one blockers
Prazosin
Cns depression
Bradycardia
Vasodilators
Hydralazine
Nitropruside
In primary hypertension - thiazides diuretics , ACE /arb , dhp
