Clinical Hypertension Flashcards

1
Q

CVD/risk is environmental more then genetic!

A

Seen within different countries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Why is 140/90 not true as ‘normal”

A

So variable!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Why is there such an issue in BP

A
  • Causes cerebrovascular accident (stroke) : ischemic stroke(clot), haemorrhagic stroke(burst)
  • Transient ischemic attack (TIA): a reversible stroke
  • CVD, MI, angina
  • kidney damage
  • peripheral vascular disease
  • aortic aneurysm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Synergy of risk factors

A

Smoking (worst), blood cholesterol, gender, age, diabetes all synergise to increase the risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

CVD explain

A

BP ~ 18% risk increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How do we know all this info about BP

A

From cohort studies (british doctors studies)

RCT: show us treatment effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Age is worse then High BP

A

if you look at mortality rates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Differing B at times of the day/year

A

morning: low
midday: high
evening: low

Winter: lower
summer: high

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How has college students BP been declining even with weight rising?

A

Better prenatal care.
Dietary Fats reducing BP

Not really known about fully.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Indigenous people

A

95/60

-low salt, etoh, high exercise, low fat, small

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Age affecting BP

A

75+ = 78% males and 75% females

35-44 = 16% males and 8% females

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Ethnicity affecting BP

A

Maori and PI high (5-6) then european

Asian higher then european

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Why are women more likely to get treated then men??

A

Because they are more likely to come in.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How is BP usually measured?

A

Screening in GP via

  • mercury sphygomomanometer
  • electronic in future
  • wrist BP measure (same size)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Causes of BP

A

> 95% lifestyle

also

  • kidney disease
  • adrenal (3 hormones)
  • co-arctation of the aorta (DA)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Diagnosis of BP

A

3 visits
average of last 2 BPs

if 180/105 see in few weeks
250/130 see later in day

17
Q

Checking in physical exam

A

Coarctation of aorta: radiofemoral delay

Renal Bruit

Pulse for arrhythmias

BMI

Pulse/peripheral pulses

18
Q

Investigation/other risk factors

A

Kidney function

Endocrine system, (Na+, K+)

Urine for albumin and cast
FBC for large red cells

GGT liver for signs of heavy alcohol intake

fasting glucose
cholesterol
chest x-ray, ECG, or ECHO

19
Q

Who to treat?

A

BP >170/100

5 year risk >15%

20
Q

What to get the patient to change!

A

Drug therapy easiest
Exercise
Smoking cessation!!

Diet change
salt reduction

21
Q

Smoking =

A

adding 40kg

in terms of risk