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First Year med - dundee > C23. Hypertension > Flashcards

C23. Hypertension Flashcards

1
Q

what is hypertension

A

high blood pressure. Medical condition characterized by persistently elevated pressure within large arteries

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2
Q

what is BP measured in

A

mm of mercury

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3
Q

how do you write BP

A

systolic over diastolic mm of mercury

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4
Q

what is systolic pressure

A

maximum pressure within large arteries when the heart muscle contracts to propel blood through the body

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5
Q

what is diastolic blood pressure

A

the lowest pressure within the large arteries during heart muscle relaxation between beating

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6
Q

what are the determinants of blood pressure

A

Cardiac output
peripheral vascular resistance
Blood volume

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7
Q

what is cardiac output

A

volume of blood pumped by the heart per minute

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8
Q

what is peripheral vascular resistance

A

the resistance to blood flow in the peripheral blood vessels

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9
Q

what are the determinants of hypertension

A

altered BP regulation
Genes
lifestyle
environment

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10
Q

what numbers define hypertension

A

sustained SBP >140
sustained DBP >90

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11
Q

what are the two types of hypertension

A

essential and secondary

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12
Q

what is essential/primary hypertension

A

no clear single causes
complex genetic background and environmental factors
most common form of hypertension in adults

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13
Q

what is secondary hypertension

A

specific underlying cause
5-10% of cases of adults
70-85% cases in children

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14
Q

so the definition of essential Hypertension is…

A

“Essential Hypertension” is a persistently elevated blood pressure without an identifiable secondary cause

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15
Q

what are some manual auscultatory devices used in practice

A

BP cuff, stethoscope

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16
Q

what are some automated electronic devices used in practice

A

digital/electronic bp monitor

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17
Q

in what environment would you measure BP and how would you have your patient

A

use a relaxed setting with a person quiet and seated

18
Q

what should you do before taking a BP reading

A

check the pulse if its irregular take the BP manually and ensure the device is validated and you are using the right sized cuff

19
Q

what is a ABPM

A

ambulatory Blood pressure monitor

20
Q

which method of taking blood pressure is the most accurate and useful and why

A

ABPM because it provides multiple readings in conditions that reflect the usual environment like daily activities and sleep

21
Q

so hypertension must be diagnosed with ABPM or……….

A

Home BP

22
Q

how many readings do you need an hour if you are using ABPM

A

at least two measurements per hour during the person’s usual waking hours (usually 14/day).

23
Q

how many measurements do you need if you are using a HBPM

A

two consecutive seated measurements 1 minute apart
BP is recorded x2 a day for min of 4 days and preferably a week

24
Q

when using HBPM which measurements are discarded

A

the first days measurements and then an average is used for the rest

25
Q

what is it called when BP goes up because it is being measured at the GP

A

white coat effect

26
Q

what is masked hypertension

A

having normal BP in clinic but elevated BP at home

27
Q

what could eb possible reasons for masked hypertension

A

young age, male, stress (ie in calm moments there bp could be almost normal )

28
Q

what are the stages of hypertension

A

1, 2 and severe

29
Q

what is stage one hypertension

A

office BP is 140/90 or higher
ABPM/HBPM daytime average is 135/85 or higher

30
Q

what is stage 2 hypertension

A

office BP is 160/100 or higher
ABPM/HBPM daytime average is 150/95 or higher

31
Q

what is severe hypertension

A

office SBP is 180/90 or higher
office DBP is 110 or higher

32
Q

what tests should you do for hypertensive people to assess their organ damage

A

test urine for presence of proteins
blood to measure glucose, cholesterol, electrolytes, creatinine
arrange an ECG - (LVH?)
examine fundi for hypertensive retinopathy

33
Q

what conditions can be developed due to prolonged HBP

A

Left Ventricular Hypertrophy - can lead to heart failure
raised creatinine levels - kidney damage
albumin present in urine - kidney damage
retinopathy

34
Q

what are established vascular diseases linked to HPB

A

Ischaemic Heart Disease
Cerebrovascular Disease
PVD
diabetes

35
Q

how do you asses someone for Hypertension

A

Medical history
Family History
Smoking
Alcohol
Sleep history
CV examinations (pulses, bruits)
ABPM ? HBPM
examine Fundi

36
Q

what are the classes of retinopathy

A

Grade I, II, III, IV

37
Q

why do we check the fundi in hypertensive patients

A

Examining the fundi is crucial for detecting hypertensive retinopathy, which can indicate the severity and duration of hypertension. It helps in early detection, assessing the overall cardiovascular risk, monitoring progression, and preventing vision loss.

38
Q

what is secondary hypertension

A

Secondary hypertension is high blood pressure caused by another medical condition.

39
Q

what are some common causes of secondary hypertension

A

Obstructive sleep apnoea
renal disease
aldosteronism
renovascular disease

40
Q

what are the more uncommon causes of secondary hypertension

A

Cushing’s
Hyperparathyroidism
aortic coarctation

First Year med - dundee (54 decks)

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