CVD - Hypertension Flashcards
Stage 1 Hypertension? Clinical and home values?
Clinical: 140/90 or higher
Home: 135/85 or higher
Stage 2 Hypertension? Clinical and home values?
Clinical: 160/100 or higher
Home: 150/95 or higher
Stage 3 Hypertension? Clinical and home values?
Greater than 180/120 mmHg
MEDICAL EMERGENCY
What BP value and stage is considered medical emergency?
Stage 3 & over 180/120mmHg
How long should antihypertensives be taken before seeing effectiveness?
4 weeks
Hypertension treatment for under 55 year olds?
1) ACE or ARB
2) ACE or ARB + CCB/Thiazide
3) ACE/ARB + CCB + Thiazide
4) if potassium lower 4.5: + low dose Spironlactone
If potassium higher 4.5: + Alpha/Beta blocker
Hypertension treatment over 55 years or any age AFRICAN/CARRIBEAN?
1) CCB
2) CCB + ACE/ARB or Thiazides
3) CCB + ARB/ACE + Thiazides
4) If less than 4.5mmol/L -> Low dose Spironlactone
If over than 4.5mmol/L -> Alpha/Beta blocker
BP target 80+ pt? Clinical and Home values?
Clinical: 150/90 mmhg
Home: 145/85 mmhg or lower
Isolated systolic hypertension is common in?
60 Years +
ACE side effects?
C - Cough
H - Hyperkalaemia
H - Hepatic Failure
A - Angioedema
R - Renal Impairment
D - Dizziness/ Headache
ARB is the same but no cough/Angioedema
Diabetic BP target?
Below 140/80 mmHg
Diabetic BP range if Kidney, eye or cerebrovascular disease present
130/80
Diabetic Nephropathy Treatment?
ACE or ARB
Antihypertensive in Pregnancy? 1st line? 2nd line? 3rd line?
1st line: Labetalol
2nd line: Nifidipine
3rd line: Methyldopa
Methyldopa max dose?
3g adult max dose
Monitoring of pregnancy antihypertensive?
Monitor FBC & LFT for 6-12 weeks
&
If there’s unexplained fever
If Methyldopa is taken during pregnancy, why restart usual hypertensive med after birth? And when exactly?
Methyldopa can cause Depression
So within 2 days after birth start!!
ACE interactions increased risk of?
Increase risk of Renal Failure
Increased Hyperkalaemia
Increased risk of Volume Depletion
Increased levels of Lithium
Cardioselective Beta blockers?
Bisoprolol
ATenolol
Metoprolol
Acebutanol
Nebivolol
BATMAN
Water soluble beta blockers?
Celiprolol
Atenolol
Nadolol
Sotalol
water CANS
What Betablockers given if pt is experiencing nightmares? And why?
Celiprolol
Atenolol
Nadolol
Sotalol
Reason is it less likely to cross BBB
Where are water soluble Betablockers excreted?
Kidneys
Intrinsic sympathetic beta blockers or COLD EXTREMETIES ONES?
Ice
Pindolol
Acebutolol
Celiprolol
Oxyprenolol
ICE PACO
Betablocker side effects?
- Bradycardia or HF
- Masks signs of Hypoglycaemia
- Can cause hyperglycaemia
- Bronchospasms
CCB Side effects?
- Dizziness
- Ginger Hyperplasia
- Vasodilatory effects (Typical ccbs)
- Av Blocks (Rlccb)
Why are Rate limiting CCB not given in QT prolongation?
Cause AV blocks
Pre-eclampsia - What should be used?
Aspirin from Week 12 Till birth
WHAT Bp is classed as pre eclampsia?
Greater than 140/90
Bp target for pre eclampsia?
135/85mmHg
What is pre eclampsia?
Either
- New onset of BP over 140/90
& Co-existing condition: CKS, diabetes, autoimmune, chronic BP
Or
Two or more moderate factors:
First pregnancy, age 40+, pregnancy interval more than 10 years, BMI 35+, Family history, multiple pregnancies
If a woman wishes to breastfeed postnatal period, which antihypertensive to take?
Enalapril
If a BLACK woman wishes to breastfeed postnatal period, which antihypertensive to take?
Nifedipine
Or
Amlodopine (if they’ve had before)
Advice breastfeeding while taking antihypertensive?
Monitor baby on:
-Hypertension
-Lethargy
-Drowsy
-Cold Peripheries
-Poor feeding
What is given to females with pre eclampsia where birth considered in 7 days?
IM Betamethasone for foetal maturation
2 Side effects of Hydralazine HCL (alone)?
- Tachycardia
- Fluid Retention
Disadvantages of Clonidine HCL?
Sudden withdrawal can cause severe rebound hypertension
ACE & NSAIDS together is there a problem?
Yes -> Renal Damage
Which ACE to take BD?
Captopril
Which ACE 30-60mins before food
Perindopril
Betablocker side effects in Angina?
Sudden withdrawal -> Exacerbate angina
Therefore gradual dose reduction required.
Side effect of Sotalol?
QT Prolongation
Betablocker stable in HF over 70 years?
Nebivolol
Which 2 Betablockers reduce mortality in stable HF?
Bisoprolol & Carvedilol
Which Betablocker can reverse symptoms clinical thyrotoxicosis in 4 days?
Propranalol
Betablocker monitoring?
Lung function test
Which CCB for anal fissure (chronic)?
Diltiazem HCL
Overdose Diltiazem side effect?
Cardiac depressant -> Hypotension, Arrhythmias
Diltiazem over 60mg prescribing info?
Brand Name needs to be prescribed over 60mg
Which CCB can inhibit labour?
Lacidipine
Nifedipine prescribed by?
Brand name
Vasospastic Peripheral Vascular disease
RAYNAUDS TREATMENT?
AVOID COLD & SMOKING
&
NIFEDIPINE !!!!