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Year 3 Academic Weeks > A7- Hypertension > Flashcards

A7- Hypertension Flashcards

1
Q

Definition of Arterial Blood Pressure

A

Definition: the force exerted by the blood against the walls of the blood vessels

Adequate to maintain tissue perfusion during activity and rest

Arterial blood pressure: primary function of cardiac output and vascular resistance

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2
Q

The major factors that help to maintain blood pressure (BP) include the _________ ______ ________ and the _______

A

The major factors that help to maintain blood pressure (BP) include the sympathetic nervous system and the kidneys

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3
Q

Increasing blood pressure is associated with a progressive increase in the risk of _____ and __________ _____

A

Increasing blood pressure is associated with a progressive increase in the risk of stroke and cardiovascular disease

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4
Q

What is Systemic Hypertension

A

Hypertension is currently defined as a usual BP of 140/90mmHg or higher, for which the benefits of drug treatment have been definitively established in randomised placebo controlled trials

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5
Q

What is the recommended bp for high risk patients, especially pts with CAD

A

For certain high risk patients, especially those with CAD, the recommended medical treatment threshold recently has been lowered to 130/80mmHg

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6
Q

Define the classes of HTN

A
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7
Q

How do you calculate pulse pressure

A

PP = SBP- DBP

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8
Q

WHat does pulse pressure indicate

A

greater stiffness in large conduit arteries, primarily the thoracic aorta

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9
Q

pulse pressure is a measure of….

A

synamic cyclic stress during systole

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10
Q

When is PP better than BP

A

PP may be a better marker of increased CV risk than either systolic BP or diatolic BP alone in older persons

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11
Q

How do you examine patients with HTN

A

Appropriate measurement of BP in both arms

  • Optic fundi (eyes)
  • Calculation of BMI (waist circumference may also be useful)
  • Auscultation for carotid, abdominal and femoral bruits
  • Palpation of the thyroid gland
  • Thorough examination of heart and lungs
  • Lower extremities for oedema and pulses
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12
Q

What are some basic and optional testing for laborstory tests for primary hypeternsion

A
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13
Q

What is the mnemonic for secondary causes of HTN

A
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14
Q

WHat are some drugs that raise BP

A
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15
Q

These findings suggest which endocrine disorder?

A
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16
Q

These findings suggest which disorder?

A
17
Q

These findings suggest which disorder?

A
18
Q

What Blood pressure measurement do you

A
  • BP should be measured at least twice after 5 minutes of rest, with the patient seated in a chair, the back supported, and the arm bare and at heart level
  • A large adult sized cuff should be used to measure BP in over weight adults because the standard-sized cuff can spuriously elevate readings
  • Tobacco and caffeine should be avoided for at least 30 minutes
  • BP should be measured in both arms and both patient and doctor should not be talking during BP measurement
  • After 3 minutes of standing, the later to exclude a significant postural fall in BP, particularly in older persons and in patients with diabetes or other conditions (e.g. Parkinson’s disease) that predispose to autonomic insufficiency
19
Q

What is recommended for patient with mild to moderate elevation in BP

A

They should not be diagnosed with hypertension unless the BP remains elevated after three to six visits unless there is evidene of ongoing end-organ damage

20
Q

What is the main cause of white coat htn

A

anxiety

21
Q

what is diagnosis of white coat hypertension

A

The diagnosis of white coat htn (also called isolated clinic or office hypertension) is applied to patients with office readings that averafe more than 140/90 mmHg and reliabl eout-of-office readings that average less than 140/90 mmHg

22
Q

How can you minimise white coat effect

A

Bp taken by nurse or technician rather than a clinician

23
Q

How is ABPM detrermined

A

ABPM is determied using a device worn by the patient that takes blood pressure (BP) measurements over 24 gto 48 hour period usually every 15 t 20 minutes during the daytime and every 30 to 60 minutes during sleep.

These blood pressure are recorded on the evice and the averafe day or night blood pressures are determined from the data by a computer

24
Q

ABPM should be considered in the following situations:

A

Suspected white coat hypertension

Suspected episodic hypertension

Hypeetension resistant to increasing medication

Hypotensive symptoms while taking antihypertensive medications

Autonomi dysfunction

25
Q

What is the alternative if ABPM is not available

A

Self-recorded home BP measurements

26
Q

As many as 10 to 40 percent of patients who are normotensive by conventional clinic measurement are hypertensive by ABPM

What is the ohenomenon called

A

Masked hypertension or isolated ambulatory hypertension

27
Q

Why treat hypertension?

A

to decrease

-Cerebrovascular Accidents

Coronary events

Heart failure

Progression of renal disease

Progression to severe hypertension

All cause mortality

28
Q

Lifestyle measures in management of hypertension

A
  • Offer lifestyle advice to all patients undergoing assessment or treatment for hypertension.
  • Assess patients’ diet and exercise patterns and encourage appropriate lifestyle changes.
  • Advise patients to:
  • – Avoid excessive alcohol consumption.
  • – Avoid excessive consumption of coffee and other caffeine-rich products.
  • – Limit dietary sodium intake by reducing intake or substituting sodium salt.
  • Offer smoking cessation help and advice.
  • Encourage stress reduction.
29
Q

WHat is the management plan for BP lowering treatment at different initial office BP Levels

A
30
Q

Hypertension drugs guidelines

different stages

A
31
Q

What is the core drug treatment strategy for uncomplicated hypertension

A
32
Q

what is a symplicity catheter

A

The Symplicity Spyral catheter positions electrodes to generate 360 degrees of ablation, and can treat the renal branches to maximise the probability of complete denervation. Reaches the main artery, branches and accessory vessels within a broad diameter range (3–8mm) to treat a wide range of patients

33
Q

Hypertensive Emergency Treatment for disease specific recommendations

Acute ischemic stroke

Intracranial Haemorrahge

SAH

Hypertensive Encephalopathy

A
34
Q

WHat are the drug used for HTN in pregnancy

remember Her New Lab Method

A

Hydralazine

Nifedipine

Labetalol

Methyldopa

35
Q
A

Year 3 Academic Weeks (40 decks)

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