Cardiology 7 - Hypertension

Question 1

secondary causes of hypertension x4

Answer 1

95% is essential

otherwise
Renal disease (if very high consider Renal Art Stenosis)
Obesity 
Pregnancy-induced / pre-ec
Endocrine - renin aldosterone ratio

Question 2

5 x complications of hypertension

Answer 2

ischaemic heart disease 
CVA 
hypertensive retinopathy
hypertensive nephropathy 
heart failure

Question 3

diagnosing HTN

Answer 3

clinic reading >140/90
ambulatory >135/85

classed as stage 2 if >160/100, >150/95 home

Question 4

5 key medications for HTN treatment

Answer 4

ACE inhibitor - ramipril 1.25mg to 10mg OD
Beta blocker - bisoprolol 5mg to 20mg OD
Calcium ch blocker - amlodipine 5mg to 10mg OD
Diuretic - thiazide - indamapide 2.5mg OD
ARB - candesartan 8 to 32mg OD

Question 5

when to use ARB

Answer 5

if ACEx not tolerated due to cough or not white

Question 6

management of HTN pathway

Answer 6

lifestyle advice
screen end organ damage
step 1- <55 years not black start on ACEx, if otherwise start on calcium ch blocker
step 2- add cal channel blocker for young + white, add ARB otherwise
step 3 - add thiazide for all
step 4 - if potassium higher than 4.5 increase thiazide dose, if not add spironolactone

monitor U+Es regular like

Question 7

treatment targets in BP management

Answer 7

if <80, aim 140/90

if older aim 150/90

Question 8

diabetics and HTN

Answer 8

aim 130/80

ACEx for them as good for renal complications

Question 9

exceptions for diabetics and ACEx

Answer 9

if pregnant or if black

black diabetic = ACEx AND cal channel block