Essential or secondary hypertension Flashcards

1
Q

NICE definition of HTN

A

Clinic reading persistently >140/90

24 hour reading >135/85

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2
Q

Primary/ essential HTN

A

No single disease causing the rise in BP

Complex physiological changes which occur with age

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3
Q

Secondary HTN

A

Caused by a wide range of endocrine, renal and other causes

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4
Q

Renal causes of HTN

A

Glomerulonephritis

Chronic pylenonephritis

Adult polycystic kidney disease

Renal artery stenosis

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5
Q

Endocrine causes of HTN

A

Primary hyperaldosteronism

Phaeochromocytoma

Cushing’s syndrome

Liddle’s syndrome

Congenital adrenal hyperplasia

Acromegaly

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6
Q

Other causes of HTN

A

Glucocorticoids

NSAIDs

Pregnancy

Coarctation of the aorta

COCP

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7
Q

Symptoms

A

Typically no symptoms unless BP very high

Headaches, visual disturbances, seizures

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8
Q

Complications of HTN

A

IHD

Cerebrovascular accident

Hypertensive retinopathy

Hypertensive nephropathy

Heart failure

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9
Q

Assessing end-organ damage

A

Fundus examination for retinopathy

Urine albumin:creatinine ratio for proteinuria and dipstick for microscopic haematuria for nepthropathy

Bloods for HbA1c, renal function and lipids

ECG for cardiac abnormalities

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10
Q

Medical management step 1

A

Aged <55 and non-black use ACEi

Aged >55 or black of African or African-Caribbean descent use calcium channel blocker

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11
Q

Step 2

A

ACEi and CCB or thiazide like diuretic OR

CCB and ACEi/ARB or thiazide like diuretic

If black then use ARB instead of ACEi

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12
Q

Step 2

A

ACEi and CCB or thiazide like diuretic OR

CCB and ACEi/ARB or thiazide like diuretic

If black then use ARB instead of ACEi

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13
Q

Step 3

A

ACEi/ARB + CCB + thiazide like diuretic

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14
Q

STep 4

A

Same as three plus an additional agent

K+<4.5 use potassium sparing diuretic

K+>4.5 use an alpha blocker or beta blocker

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15
Q

Treatment targets

A

<80 aim for <140/<90

> 80 aim for <150/<90

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