Blood pressure management

Question 1

Outline the treatment for hypertension

Answer 1

1st line: ACE-Is/ARBs or CCBs

2nd line:
-If on an ACE-I: ACE-Is/ARBs + CCBs or thiazide-like diuretics
-If on a CCB: CCB + ACE-I/ARB or thiazide-like diuretic

3rd line: ACE-I/ARBs + CCB + thiazide-like diuretic

4th line:
-If K+ <= 4.5 then low-dose spironolactone
-If K+ >4.5 then AB OR bb

Question 2

T2DM (any age or origin)
or
<55 but not Black or Afro-Carribean

Start them on….

Answer 2

ACE-Is: Ramipril, Lisinopril

If they develop a cough then:
ARBs: Candesartan, Losartan

Question 3

> =55 (not T2DM)
or
Black African (not T2DM)

Start them on….

Answer 3

CCBs: Amlodipine, Nifedipine

*Verapamil is not used in HTN management

Question 4

Examples of thiazide-like diuretics

Answer 4

Indapimide, chlorothiazide