Cardiovascular: Hypertension

Question 1

What is BP target for <80 yearss old?

Answer 1

<140/90

Question 2

What is BP target for <80 years old with

• atheosclerotic CV
• diabetes with kidney/eye/cerebrovascular disease

Answer 2

<130/80

Question 3

What is BP target for renal disease?

Answer 3

<140/90

Question 4

What is BP target for:

• CKD
• Diabetes
• Proteinuria

Answer 4

<130/80

Question 5

What is BP target for type 2 diabetic (without complications) in <80 and >80

Answer 5

<80= <140/90 (only lower if complications) 
>80= <150/90

Question 6

In what circumstances would you treat (medically) stage 1 hypertension (140/90)?

Answer 6

All >80 
Only <80 if: 
- target oran damage e.g. CVT/ventricular hypertrophy/retinopathy
- CVD and QRISK >10%
- renal disease
- diabetes

Question 7

What is classed as stage 2 hypertension

Answer 7

160/100

Question 8

What is stage 1 and 2 treatment for <55 (or type 2 diabetes)

Answer 8

ACE or ARB

Step 2: CCB or thiazide like diuretic

Question 9

What is step 1 and 2 management for black african/caribbean or >55?

Answer 9

1. CCB

2. ACE or ARB or thiazide like diuretic

Question 10

What is target BP for HTN in pregnancy?

Answer 10

<150/100 chronic

<140/90 chronic and if target organ damage or given birth

Question 11

What anti-hypertensives are used in pregnancy

Answer 11

Labetalol
Methyldopa
MR nifedipine

Question 12

Name side effects of ACEi

Answer 12

Dry cough 
angioedema
hyperkalaemia 
Anaphylactoid reactions
Renal nephrotoxic in AKI 
Cholestatic jaundice - LFT 3xUL 
ulcers
Taste disturbancee
hypoglycaemia

Question 13

What are side effects of calcium channel blockers

Answer 13

oedema /swelling
flushing 
headaches
gingival hyperplasia
erectile dysfunction

Question 14

which CCB are used in HTN and why?

Answer 14

Dihydropyridines - more selective for the vasculature

- amlodipine/felodipine/lacidipine/lercandipine/nifedipine

Question 15

What interactions are involved with CCB?

Answer 15

Enzyme inhibitors can increase CCB concentrations e.g. grapefruit juice, ssodium valp, fluconazole, cimetidine, macrolides, quinolones, omeprazole

Question 16

Which antihypertensive is used in hypertensive emergency?

Answer 16

Hydralazine - with long acting nitrate under specialist

Question 17

What is a warning label for perindopril

Answer 17

30-60 min before food

Question 18

All ACEi are taken OD except which?

Answer 18

Captopril - BD

Question 19

What are some interactions of ACEi?

Answer 19

Other drugs that cause hyperkalaemia - K+ sparing/aldosterone antag, Aliskeren

Nephrotoxics- NSAID

Hypotension when given with diuretics- profound HTN