Cardio- Hypertension

Question 1

How many different stages of hypertension and the ranges for them?

Answer 1

Stage 1: >140\90mmHg (home - >135/85mmHg)
Stage 2: >160/100 mmHg (home - >150/95mmHg)
Severe hypertension: >180/110mmHg

Question 2

Initial management for stage 1 and stage 2 suspected hypertension?

Answer 2

Ambulatory monitoring offered

Question 3

Treatment for stage 1 hypertension

Answer 3

Treatment offered if under 80 and diabetic or signs of end organ damage or CVS disease or renal impairment or 10 year risk >20%
Otherwise life style modifications reduce weight, smoking cessation and moderate salt intake

Question 4

Treatment for stage 2 hypertension

Answer 4

Everyone offered treatment ACEi or calcium channel blocker

Question 5

Severe hypertension management

Answer 5

Consider treatment immediately without ABPM

Question 6

Pharmacological hypertension treatment criteria

Answer 6

Diabetic = 1) ACEi (lisinopril/ramipril 2) + CCB
Under 55 non-African ethnicity= 1) ACEi 2) +CCB
Over 55= 1) CCB (nifedipine/diltiazem/amlodipine) 2) +ACEi
African or Afro-Caribbean ethnicity= 1) CCB 2) +ACEi

Step 3= thiazide like diuretic
Step 4= low dose spironolactone or alpha/beta blocker