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Cardio - mine > Blood pressure > Flashcards

Blood pressure Flashcards

1
Q

what is stage 1 hypertension

A

clinical BP = 140/90 with ABMP or HBPM average BP = 135/85

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2
Q

what is stage 2 hypertension

A

clinic BP = 160/100 with ABMP or HBPM average BP = 150/95

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3
Q

what is stage 3 hypertension

A

clinic systolic > 180

clinic diastolic >110

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4
Q

if clinic BP is 140/90 or higher what should be done next

A

take a second measurement
offer ABMP to confirm diagnosis
offer HBPM is ABMP can’t be tolerated

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5
Q

how is HBPM measured

A

two consecutive measurements are taken at least 1 min apart with the person seated

BP is recorded twice a day, ideally morning and night for minimum 4 days, ideally 7

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6
Q

what is stage 3 hypertension also known as

A

severe hypertension

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7
Q

what should be done if a patient has suspected severe hypertension

A

start anti-hypertensives immediately while waiting for results of ABPM/HBPM

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8
Q

what should be done while awaiting confirmation of hypertension

A

investigations of target organ damage (e.g LV hypertrophy, CKD, hypertensive retinopathy)

formal assessment of cardiovascular risk

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9
Q

what is the first line treatment for a patient under 55 who is white

A

ACEI

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10
Q

what can ACEI be substituted for if it isn’t tolerated

A

ARB

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11
Q

what is the most common side effect for ACEI

A

dry cough

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12
Q

give examples of ACEIs

A

lisinopril, ramipril

ends “-pril”

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13
Q

give examples of ARBs

A

losartan, valsartan

ends “-sartan”

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14
Q

what is the side effect of ARBS

A

increase in blood potassium

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15
Q

what is the first line treatment for a black patient

A

Ca+ channel blocker

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16
Q

what is the first line of treatment for a patient >55

A

Ca+ channel blocker

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17
Q

what is the side effect of Ca+ channel blocker

A

swollen feet/ankles

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18
Q

give examples of Ca+ channel blocker

A

amlodipine, diltiazem, verapamil

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19
Q

what is the 2nd line of treatment

A

Ca+ channel blocker and ACEI/ARB

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20
Q

what is the 3rd line of treatment

A

Ca+ channel blocker and ACEI/ARB and thiazide-diuretic

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21
Q

what is the 4th line of treatment

A

refer to expert

add alpha or beta blocker

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22
Q

what type of hypertension would require a 4th step

A

resistant hypertension

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23
Q

give examples of thiazide diuretics

A

hydrochlorthiazide
indapamide
chlorthalidone

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24
Q

what are the common side effects of thiazide diuretics

A

GOUT, INCREASED URINATION, low sodium

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25
Q

what are the common side effects of alpha blockers

A

low BP

dizziness

26
Q

give examples of alpha blockers

A

prazocin

doxazocin

27
Q

what are common side effects of beta blockers

A

fatigue

depression

28
Q

give examples of beta blockers

A

metoprolol
atenolol

ends “-olol”

29
Q

what is essential hypertension

A

hypertension of unknown cause

30
Q

what is secondary hypertension

A

hypertension resulting from a specific and potentially treatable cause

31
Q

what is used to confirm white coat hypertension

A

AMBP

32
Q

what non-pharmalogical interventions are recommended for hypertension

A 
BMI<25
low fat and Na diet
limit alcohol intake
increase fruit, veg, and oily fish
stop smoking
33
Q

what is the mechanism of action of ACEI

A

inhibits the conversion of angiotensin 1 to angiotensin 2

34
Q

what is the mechanism of action of ARB

A

blocks the effects of angiotensin 2 at the AT1 receptor

35
Q

how can MAP be calculated

A

diastolic + 1/3 (systolic - diastolic)

[(2 x diastolic) + systolic]/3

36
Q

what is a normal MAP

A

70-105

37
Q

what is a normal systolic

A

<140

38
Q

what is a normal diastolic

A

<90

39
Q

what is pulse pressure

A

difference between systolic and diastolic BP

40
Q

what are the main resistance vessels

A

arterioles

41
Q

where are baroreceptors located

A

carotid bifurcation and the aortic arch

42
Q

what are baroreceptors important for

A

moment-to-moment BP regulation

43
Q

what is the baroreceptor reflex to DECREASED BP

A

decreased baroreceptor firing which:

decreases vagal activity and increases sympathetic activity + constrictor tone

this causes: increased HR, SV and vasoconstriction

44
Q

what is the baroreceptor reflex to INCREASED BP

A

increased baroreceptor firing which:

increases vagal activity and decreased sympathetic activity + contractor tone

this causes: decreased HR, SV, and vasodilation

45
Q

what are the 3 hormone pathways which control BP

A

RAAS
ADH (vasopressin)
NP

46
Q

briefly describe the RAAS pathway

A

renin is released and causes angiotensinogen to be converted to angiotensin 1. this is then converted to angiotensin 2 by ACE. angiotensin 2 stimulates release of aldosterone.

47
Q

what is the rate limiting step in the RAAS pathway

A

renin secretion

48
Q

where is renin released from (RAAS pathway)

A

the kidney

49
Q

what is the role of renin (RAAS pathway)

A

converts angiotensinogen to angiotensin 1

50
Q

where is angiotensinogen produced (RAAS pathway)

A

the liver

51
Q

where is angiotensin 1 formed (RAAS pathway)

A

the blood

52
Q

where is ACE produced (RAAS pathway)

A

pulmonary vascular endothelium (lungs)

53
Q

what is the role of ACE (RAAS pathway)

A

converts angiotensin 1 to angiotensin 2

54
Q

what does angiotensin 2 do (RAAS pathway)

A

stimulates aldosterone release
vasoconstriction
increases thirst
increased ADH release

55
Q

where is aldosterone produced

A

adrenal cortex

56
Q

what does aldosterone do (RAAS pathway)

A

increases BP
increased plasma volume
increased Na and H20 reabsorption in kidneys

57
Q

what does NP (natriuretic peptide) do

A

causes excretion of salt and water via the kidneys = decreases blood volume and BP

58
Q

what are the 2 types of NPs, where are the located

A

atrial NP = stored in atrial muscle cells

brain-type NP = synthesised by heart ventricles, brain, and other organs

59
Q

what systems acts as a counter-regulatory system for RAAS, how?

A

NP, decreases renin release

60
Q

where is ADH synthesised and stored

A 
synthesised = hypothalamus
stored = pituitary gland
61
Q

what does ADH do

A

increases reabsorption of water (increases plasma volume + BP)
causes vasoconstriction

Cardio - mine (15 decks)

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