Essential or secondary hypertension Flashcards
Give the broad definition of hypertension:
the persistent evaluation of blood pressure in the systemic arterial circulation
In which ethnic groups is hypertension most common?
black African and African Caribbean
Why is it that women have a lower blood pressure at all ages until menopause?
female sex hormones protect against raised blood pressure
What is systolic blood pressure?
the peak arterial pressure during cardiac contraction
What is diastolic blood pressure?
the lowest arterial pressure during cardiac relaxation
Describe how blood pressure should be taken in clinical practice (2):
1) take after 5 minutes of uninterrupted rest with the back supported and legs uncrossed
2) you should take 2 or more subsequent BP readings and calculate the mean or take the lowest of them
What is an ambulatory measure of blood pressure?
portable device that measures BP across 24 hour periods often at 30 minute intervals, giving a broader average
What is combined hypertension?
where both systolic and diastolic blood pressure are elevated
What is isolated systolic hypertension:
where systolic blood pressure is elevated but diastolic blood pressure is decreased
What is orthostatic hypotension?
a sustained fall in blood pressure within 3 minutes of assuming an upright position of more than 20mmHg systolic or 10mmHg diastolic
What is primary hypertension?
raised blood pressure with no singular identifiable cause (90% of hypertension cases)
What is secondary hypertension?
Elevated BP with a specific cause
Give the equation for blood pressure:
BP=CO x TPR
What is resistant hypertension?
uncontrolled blood pressure despite the use of at least three separate antihypertensives
Give 4 lifestyle causes of hypertension:
- High salt intake
- Lack of exercise
- Alcohol
- recreational drug use
Name 3 drugs that can cause hypertension:
1) oral contraceptive pill
2) NSAIDs
3) corticosteroids
Name 4 causes of secondary hypertension using ROPE:
1) R: renal disease (increase in circulatory volume)
2) O: obesity
3) P: pregnancy
4) E: endocrine disorders
Name and explain 4 endocrine causes of hypertension:
- Hyperaldosteronism (increases salt and water retention)
- Pheochromocytoma (increased adrenaline increases BP)
- Cushing’s syndrome (cortisol increased blood glucose which increases the circulatory volume
- Acromegaly - growth hormone increases blood glucose which increases circulatory volume
What is pre-eclampsia?
pregnancy-induced hypertension with the presence of proteinuria
what are 2 symptoms of pre-eclampsia?
- Seizures
- Pitting oedema
Name 5 groups of anti-hypertensive drugs:
1) ACE inhibitors
2) angiotensin II receptor blockers
3) beta blockers
4) calcium channel blockers
5) diuretics
Give an example of a thiazide diuretic:
indapamid
Give an example of a potassium sparing diuretic:
Spironolactone
How do beta blockers reduce BP?
They stimulate vasodilation through renin inhibition
