Cardiovascular: Hypertension Flashcards
What is BP target for <80 yearss old?
<140/90
What is BP target for <80 years old with
- atheosclerotic CV
- diabetes with kidney/eye/cerebrovascular disease
<130/80
What is BP target for renal disease?
<140/90
What is BP target for:
- CKD
- Diabetes
- Proteinuria
<130/80
What is BP target for type 2 diabetic (without complications) in <80 and >80
<80= <140/90 (only lower if complications) >80= <150/90
In what circumstances would you treat (medically) stage 1 hypertension (140/90)?
All >80 Only <80 if: - target oran damage e.g. CVT/ventricular hypertrophy/retinopathy - CVD and QRISK >10% - renal disease - diabetes
What is classed as stage 2 hypertension
160/100
What is stage 1 and 2 treatment for <55 (or type 2 diabetes)
ACE or ARB
Step 2: CCB or thiazide like diuretic
What is step 1 and 2 management for black african/caribbean or >55?
- CCB
2. ACE or ARB or thiazide like diuretic
What is target BP for HTN in pregnancy?
<150/100 chronic
<140/90 chronic and if target organ damage or given birth
What anti-hypertensives are used in pregnancy
Labetalol
Methyldopa
MR nifedipine
Name side effects of ACEi
Dry cough angioedema hyperkalaemia Anaphylactoid reactions Renal nephrotoxic in AKI Cholestatic jaundice - LFT 3xUL ulcers Taste disturbancee hypoglycaemia
What are side effects of calcium channel blockers
oedema /swelling flushing headaches gingival hyperplasia erectile dysfunction
which CCB are used in HTN and why?
Dihydropyridines - more selective for the vasculature
- amlodipine/felodipine/lacidipine/lercandipine/nifedipine
What interactions are involved with CCB?
Enzyme inhibitors can increase CCB concentrations e.g. grapefruit juice, ssodium valp, fluconazole, cimetidine, macrolides, quinolones, omeprazole
Which antihypertensive is used in hypertensive emergency?
Hydralazine - with long acting nitrate under specialist
What is a warning label for perindopril
30-60 min before food
All ACEi are taken OD except which?
Captopril - BD
What are some interactions of ACEi?
Other drugs that cause hyperkalaemia - K+ sparing/aldosterone antag, Aliskeren
Nephrotoxics- NSAID
Hypotension when given with diuretics- profound HTN