Blood Pressure Flashcards
How fast should the cuff be deflated in BP measurement?
2 - 3 mmHg/s
What is the ratio of sBP:dBP:PP
3 : 2 :1
Is MAP closer to systolic or diastolic pressure?
Diastolic
What is the result of choosing a blood pressure cuff that is too small?
Over-estimation of BP
What is the result of choosing a blood pressure cuff that is too big?
Under-estimation of BP
What are the ranges for maximum arm circumference for small, standard and large blood pressure cuffs?
Small - 26cm
Standard - 33cm
Large - 50cm
What is a K1 Korotkov sound?
Faint tapping - artery just open
- Systolic pressure
What is a K5 Korotkov sound?
No sound - artery completely open
- Diastolic pressure
What is the auscultatory gap?
In hypertensive patients, sounds may disappear for a few seconds before the next sound reappears
How should you calculate blood pressure and how many readings should you take?
Take 2 readings - both should be within 10mmHg and use the average
What percentage of UK adults does hypertension affect?
1 in 4
- note: this rises to 50% in over 60s
What is stage 1 hypertension?
Clinic Systolic pressure > 140 / 90 mmHg
What is stage 2 hypertension?
Clinic Systolic pressure > 160 / 100 mmHg
What is severe hypertension?
Clinic Systolic pressure > 180 / 120 mmHg
What are the ranges for acceptably medically controlled hypertension?
Under 80 = 140/90 mmHg
Over 80 = 160/100 mmHg
What is the next stage when patient returns a clinic blood pressure between 140/90mmHg - 180/120mmHg?
Offer ambulatory BP monitoring to confirm hypertension diagnosis
What is the criteria for acceptable ABPM results?
- At least 2 measurements per hour during the persons usual waking hours
- At least 14 measurements
What is the criteria for acceptable HBPM results?
- 2 consecutive measurements at least 2 mins apart
- BP measured twice a day for at least 4 days, ideally 1 week
- Measurements on first day are discarded
- Average of remaining results are used
What are the 4 initial recommended tests to offer patient following hypertension diagnosis?
- Urine protein content - albumin:creatinine ratio
- Blood sample - cholesterol, GFR, HbA1C
- Examine fundi for hypertensive retinopathy
- 12-lead ECG
What are the 2 main drugs of choice for treating hypertension in patients under 55 or type 2 diabetics?
- Angiotensin receptor blockers (ARBs)
- Angiotensin converting enzyme (ACE) inhibitors
What is the medication of choice for over 55s non-diabetics or are Black-African or Afro-Caribbean?
Calcium channel blockers
What is a potential side effect of Ca channel blockers?
Oedema
