Defining Hypertension

Question 1

What risk is associated with Hypertension?

Answer 1

Cardiovascular risk, CHD and stroke

Question 2

What measurement of BP counts as stage 1 HT?

Answer 2

Clinical 140/90mmHg
At home ambulatory monitoring = 135/85

Unless diabetic or renally impaired = 130/80

Question 3

What measurement of BP counts as stage 2 HT?

Answer 3

Clinical = 160/100

At home = 150/95

Question 4

What measurement of BP counts as stage 3 HT?

Answer 4

Clinic = 180/110

Question 5

What is Essential (primary/idiopathic) hypertension?

Answer 5

HT of unknown origin = what most people have

Question 6

What is secondary HT?

Answer 6

HT associated with another primary pathology e.g. disease or medicine induced. We not that it is as a consequence of an identifiable physiological, Pharmacological or structural cause.

Question 7

What is pre-hypertension?

Answer 7

Those with systolic BP of 130-140 = on the way to stage 1 hypertension unless lifestyle is changed.

Question 8

What is isolated systolic/diastolic HT?

Answer 8

When e.g. Systolic is high but Diastolic is not

Question 9

What is white coat HT?

Answer 9

When HT is elevated in a clinical setting

Question 10

What is malignant HT?

Answer 10

Sudden onset HT 180/120 and over - will present with retinal haemorrhage and swelling in the tissues around the optic nerve.

Question 11

What are the 4 main causes of secondary HT?

Answer 11

1. ) Renal disease
2. ) Adrenal disease
3. ) Pregnancy
4. ) Drug induced (oral contraceptives, NSAIDs, steroifd)

Question 12

What are the 4 less common causes of secondary HT?

Answer 12

1. ) Obstructive sleep apnoea = intermittent hypoxia (lack of 02) = overactive sympathetic activity = remodelling of vasculature
2. )Thyroid and parathyroid disease = hyperthyroidism and hyperparathyroidism
3. ) Cancers and tumors (esp. on adrenal medulla = over production of adrenaline and noradrenaline
4. ) Congenital structural abnormalities of the heart and vasculature

Question 13

How is secondary HT treated?

Answer 13

In the same way as primary hypertension.

Question 14

What factors can make someone more susceptible to HT?

Answer 14

1.) environmental - smoking, obesity, sedentary lifestyle, alcohol, age and sex
2.) Polygenic influences i.e. genetics - suggested that some people have predispositions to an increased TPR, sympathetic activity, renin output and salt sensitivity.
Race is also a factor