Blood pressure disorders Flashcards
what defines hypertension
> 140/90 // 24hr >135/85 (ABPM - recommended)
what symptoms may appear with sevre hypertension >180 systolic or >120 diastolic
headaches, visual disturbance, seizures –> refer to specialist
what other tests are done following HTN diagnosis
U+E, HbA1c, lipids, urine, ECG, fundoscopy
what other tests are done following HTN diagnosis
U+E, HbA1c, lipids, urine, ECG, fundoscopy
when is ABPM or HBPM offered
following a BP of 140/90 (should measure both arms)
how is ABPM monitered
2 measurements per hour in a waking day
what is stage 1 hypertension
clinical BP >140/90 + HBPM >135/85
what is stage 2 hypertension
clinical BP >160/100 + HBPM >150/95
what is severe hypertension
clinical systolic > 180 or diastolic >120
how is HBPM done
take 3 readings in one sitting // twice daily // for 4 - 7 days // discard first day and average out the others
when should treatment be considered in HTN
if stage 1: 80+ + end organ damage or CVD 10 yr risk >10% // all stage 2 + 3
lifestyle advice mx for HTN
low salt (<6g a day) // low caffeine // stop smoking
1st line mx HTN in patient <55 or T2DM
ACEi (or ARB if cough)
2nd line mx HTN in patient <55 or T2DM
add a CCB or (thiazide diuretic) eg A + C or A + D
1st line mx HTN patients 55+ or black
CCB
2nd line mx HTN patients 55+ or black
add on an ACEi/ARB OR a diuretic eg C + A or C + D
3rd line HTN mx in all patients
triple therapy eg A + C +D
4th line mx for all HTN patients
K <4.5 = spironolactone // K > 4.5 = alpha or beta blocker
BP aim in patients 80+
150/90 or ABMP 145/85
BP aim in T2DM
140/90
BP aim in T1DM
135/85 (or albuminuria 130-80)
what drug is 1st line for HTN in diabetic patients regardless of age
ACEi or (ARBs in black diabetic patients)
who commonly gets orthostatic hypotension
older people, parkinsons, diabetes!, hypertension
what drug can commonly cause orthostatic hypotension
alpha blockers
