Chapter 2- Hypertension Flashcards
How do we diagnose hypertension?
ABPM - over a 24hour period. 2 readings taken per hour (during persons usual waking hours)
HBPM - 2 readings per day for ideally 7 days - with 2 consecutive readings 1minute apart at any one time. Discard reading of first day.
What are the common side effects of ACEIs?
X
What is the ‘normal’ target blood pressure (i.e in patients without hypertension)?
120/80mmHg
What is the target blood pressure for diabetics?
clinic 140/80mmHg; home 135/80mmHg
What is the target blood pressure for the elderly (>80yo)?
clinic < 150/90mmHg; home 145/85mmHg
What is the general recommended target blood pressure for those diagnosed with hypertension?
clinic <140/90mmHg; home 135/85mmHg - NICE recommends
For patients with hypertension and established CVD, diabetes in the presence of kidney, eye or cerebrovascular disease, what is the target blood pressure?
<130/80mmHg
What is the HTN guidelines for under < 55yo?
Step 1: ACEI (if not tolerated ARB)
Step 2: ACEI + CCB
Step 3: ACEI + CCB+ thiazide like diuretic
In patients with heart failure or at high risk of heart failure and uncontrolled HTN what should be given for the control of their HTN?
Thiazide-like diuretic
In patients who are <55yo who have been taking an ACEI/ARB, rather than adding on a CCB to their therapy, thiazide like diuretic should be used instead
Patients >55yo with newly diagnosed HTN and have heart failure or high risk of heart failure should be started on a thiazide like diuretic instead of a CCB
What should target blood pressure be during pregnancy?
150/100mmHg
What should target blood pressure be after birth?
140/90mmHg
How long after birth should long term HTN meds be reviewed?
2 weeks
Which drugs are used for the control of HTN in pregnancy?
Labetalol, methyldopa, MR Nifedipine
Which HTN out of three indicated for use in pregnancy, should be avoided in the first trimester?
Labetalol
Which drug is indicated for the control of HTN in the first trimester?
Methyldopa
