Cardio Hypertension Flashcards

1
Q

what to do to diagnose hypertension

A

sitting and standing bp (wait one minutre between) in BOTH ARMS

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2
Q

If clinic blood pressure is between 140/90 mmHg and 180/120 mmHg, offer

A

ambulatory blood pressure monitoring (ABPM) to confirm the diagnosis of hypertension

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3
Q

If ABPM is unsuitable or the person is unable to tolerate it, offer

A

home blood pressure monitoring (HBPM) to confirm the diagnosis of hypertension

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4
Q

When using ABPM to confirm a diagnosis of hypertension, ensure that at least

A

2 measurements per hour are taken - Use the average value of at least 14 measurements taken during the person’s usual waking hours to confirm a diagnosis of hypertension

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5
Q

When using HBPM to confirm a diagnosis of hypertension, ensure that: (4 things)

A
  1. for each blood pressure recording, 2 consecutive measurements are taken, at least 1 minute apart and with the person seated and
  2. blood pressure is recorded twice daily, ideally in the morning and evening and
  3. blood pressure recording continues for at least 4 days, ideally for 7 days.
  4. Discard the measurements taken on the first day and use the average
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6
Q

clinic bp hypertension

A

140/90

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7
Q

abpm hbpm bp over

A

135/85

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8
Q

all patients with hypertenskion should have

A

a urinalysis to check for protein
hba1c and cholesterol
fundoscopy
12 lead ecg

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9
Q

stage 1 hypertension diagnosis

A

140/90 mmHg and 160/100 mmHg, and ambulatory daytime average or home blood pressure average of 135/85 mmHg or higher (or diastolic over 90)

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10
Q

stage 2 hypertension diagnosis

A

between 160/100 mmHg and 180/120 mmHg, and ambulatory daytime average or home blood pressure average of 150/95 mmHg or higher

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11
Q

severe hypertension diagnosis

A

clinic systolic blood pressure of 180 mmHg or higher, or a clinic diastolic blood pressure of 120 mmHg or higher

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12
Q

Refer patients for specialist assessment, carried out on the same day, if they have a clinic blood pressure of

A

180/120 mmHg and higher with signs of retinal haemorrhage or papilloedema (accelerated hypertension), or life-threatening symptoms for example new onset confusion, chest pain, signs of heart failure, or acute kidney injury

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13
Q

high blood pressure should be controlled before giving

A

aspirin

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14
Q

A target clinic blood pressure below …. mmHg is suggested for patients aged under 80 years; whilst a target clinic blood pressure below …..  mmHg is suggested for patients aged over 80 years.

A

140/90

150/90

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15
Q

For ambulatory or home blood pressure monitoring (during the patient’s waking hours), a target average of below …..  mmHg is suggested for patients aged under 80 years; whilst a target average of below …. mmHg is suggested for patients aged over 80 years

A

135/85

145/85

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16
Q

SIGN (2017) instead recommend a target clinic blood pressure below …. mmHg regardless of age, whilst patients with high cardiovascular risk and target organ damage should aim for a clinic blood pressure below …. mmHg.

A

140/90 

135/85

17
Q

If an angiotensin-converting enzyme (ACE) inhibitor is not tolerated, for example because of cough, offer

A

ARB

18
Q

if African American consider

A

arb instead of ace

19
Q

what is the step 1 treatment of hypertension

A

ace or arb

20
Q

what is the step 2 treatment

A

add ccb or thiazide

21
Q

offer thiazide if there is evidence of

A

heart failure

22
Q

what is the step 3 treatment

A

ace/ arb + ccb + thiazide

23
Q

what is the step 4 treatment

A

reassess with abpm or hbpm
refer to specialist
add alpha blocker or spironolactone

24
Q

if under 55

A

ace

25
Q

if over 55 or African American first line

A

ccb

26
Q

preeclampsia bp >

A

140/90

27
Q

pregnant women at risk of developing preeclampsia are advised to take

A

aspirin

28
Q

pregnant first line hypertension

A

labetolol

29
Q

if hypertension and fitting in pregnancy give

A

magnesium sulphate

30
Q

who does sign recommend should have hypertensive treatment in renal disease

A

stage 3 > ckd
micro/macroalbuminuria ckd
dialysis

31
Q

target in renal disease

A

140/90

32
Q

target in type 1 diabetes

A

135/85 unless albuminuria or metabolic syndrome then its 130/80