Chronic Hypertension

Question 1

Chronic hypertension

Answer 1

• Consistently elevated diastolic blood pressure greater than 90 mmHg or a systolic blood pressure greater than 140 mmHg

Question 2

Causes / aetiology:

Answer 2

• 80-95% idiopathic
• Renal disease
• Renal artery stenosis
• Primary hyperaldosterism
• Cushing’s disease
• Pheochromocytoma
• Oestrogen therapy

Question 3

Long-term effects  target organ damage:

Answer 3

• Left ventricular hypertrophy  stiff, small lumen causes CO to drop quicker (predictor of cardiac mortality)
• Coronary artery disease
• Renal dysfunction
• Cerebrovascular disease
• Retinal involvement

Question 4

Pre-operative management:

Answer 4

Pre-medication  anxiolytic:
- Midazolam
- Diazepam / Valium
Stop:
- ACE & ARB  may cause hypotension after induction (NB!)
o Need to be more cautious of dropping BP too low due to their autoregulation shifts

intraoperatively
- Maintain within the 20-25 % of the patient’s baseline  NB!

Question 5

Nitroprusside

Answer 5

potent vasodilator