Final Exam - Hypertension

Question 1

What is the target blood pressure for patients who require blood pressure-lowering therapy?

Answer 1

The target is to reduce blood pressure to <140/90mmHg.

Question 2

What is considered the normal blood pressure target for individuals without hypertension?

Answer 2

Target is typically 120/80mmHg.

Question 3

What is one key rationale for using certain medications in the management of cardiovascular conditions, such as hypertension and heart disease?

Answer 3

Is to reduce premature cardiovascular morbidity and mortality.

Question 4

Apart from cardiovascular benefits, what other potential rationale is associated with drug use in managing conditions like diabetes?

Answer 4

Medications may help reduce microvascular disease affecting organs like the brain, kidney, and retinas.

Question 5

In the context of managing hypertension, what is another significant rationale for using antihypertensive drugs?

Answer 5

To reduce blood pressure, thereby lowering the risk of cardiovascular complications.

Question 6

When determining the appropriate timing to commence blood pressure treatment, what factors should be taken into consideration besides blood pressure levels?

Answer 6

It depends on whether patients have other risk factors such as diabetes, dyslipidemia, family history, and smoking, among others.

Question 7

What overarching consideration is important when deciding when to initiate blood pressure treatment?

Answer 7

Patient’s overall cardiovascular risk, not just their blood pressure readings.

Question 8

When making the decision to start blood pressure treatment, what should healthcare professionals think about regarding the appropriate blood pressure level for the individual patient?

Answer 8

The appropriate blood pressure target for the specific patient, taking into account their unique risk factors and medical history.

Question 9

How can weight reduction benefit individuals with hypertension if they are overweight?

Answer 9

Weight loss reduces the workload on the heart and lowers blood pressure.

Question 10

Why is maintaining physical activity an important non-pharmacological approach to managing hypertension?

Answer 10

Regular physical activity helps improve cardiovascular health and lower blood pressure.

Question 11

What type of dietary plan is recommended for individuals looking to control hypertension through non-pharmacological means?

Answer 11

A healthy eating plan, such as the DASH diet (Dietary Approaches to Stop Hypertension), is often recommended.

Question 12

How can smoking cessation contribute to the management of hypertension?

Answer 12

Quitting smoking reduces the risk of cardiovascular complications and helps lower blood pressure.

Question 13

Besides reducing alcohol intake, what dietary approach can help manage hypertension through non-pharmacological methods?

Answer 13

Adopting a Mediterranean-style diet, rich in fruits, vegetables, and whole grains, can be beneficial for hypertension.

Question 14

What dietary component should individuals reduce their intake of to support hypertension management non-pharmacologically?

Answer 14

Reduce their intake of saturated fatty acids, often found in high-fat animal products.

Question 15

What is the abbreviated name for drugs in the ACE-I class, which are commonly used in the treatment of hypertension?

Answer 15

ACE-I stands for Angiotensin-Converting Enzyme Inhibitors.

Question 16

Which class of antihypertensive medications includes drugs like candesartan and irbesartan?

Answer 16

Sartans or Angiotensin II Receptor Blockers (ARBs) class.

Question 17

What is the role of calcium channel blocking agents in managing hypertension pharmacologically?

Answer 17

Help relax blood vessels, leading to reduced blood pressure.

Question 17

Besides ACE inhibitors and sartans, what is one class of antihypertensive medications commonly used in the treatment of hypertension?

Answer 17

Thiazide diuretics are another common class of antihypertensive medications.

Question 18

What is the mechanism of action of ACE inhibitors such as perindopril and lisinopril in treating hypertension?

Answer 18

They reduce the conversion of angiotensin I to angiotensin II, leading to reduced vasoconstriction and sodium/water retention.

Question 19

Name a common adverse effect of ACE inhibitors, and what monitoring parameters are essential when using these drugs?

Answer 19

Cough
Monitoring parameters: Review the use of NSAIDs (if applicable), start with a low dose, and monitor renal function before and after starting.

Question 20

How do sartans like candesartan and irbesartan work to lower blood pressure?

Answer 20

Sartans prevent the binding of angiotensin II to type 1 angiotensin receptors, reducing vasoconstriction, aldosterone release, and sodium/water retention.

Question 21

Mention an adverse effect of sartans, and what monitoring parameters should be considered when using these medications?

Answer 21

Adverse effect: Dizziness
Monitoring parameters: Review the use of NSAIDs (if applicable) and monitor renal functions before and after starting.

Question 21

List two adverse effects of thiazide diuretics, and what monitoring parameters should be in place when patients are prescribed these drugs?

Answer 21

Adverse effects: Electrolyte disturbances and hyperuricaemia (gout), Hyperglycaemia (diabetes)

Monitoring parameters: Review the use of NSAIDs.

Question 22

What is the mechanism of action of thiazide diuretics, like hydrochlorothiazide, in managing hypertension?

Answer 22

Thiazide diuretics inhibit the reabsorption of sodium and chloride, leading to decreased sodium/water retention and potassium excretion, resulting in reduced blood volume and peripheral vascular resistance.

Question 23

How do calcium channel blocking agents like amlodipine and diltiazem contribute to blood pressure reduction?

Answer 23

They block the inward flow of calcium into cells in vascular smooth muscles and the heart, causing vasodilation and reducing peripheral vascular resistance.

Question 23

Name an adverse effect of calcium channel blocking agents and a monitoring parameter for these medications.

Answer 23

Adverse effect: Peripheral edema
Monitoring parameter: N/A

Question 24

What is the primary mechanism of action for beta-blockers like metoprolol and atenolol in hypertension management?

Answer 24

Beta-blockers block beta receptors in the body, reducing blood pressure and heart rate.

Question 25

Why are beta-blockers not recommended as first-line agents for uncomplicated hypertension? Mention one adverse effect and a monitoring parameter for these drugs.

Answer 25

Beta-blockers are not recommended due to their potential to induce wheezing and acute asthmatic attacks in asthmatic patients.
Monitoring parameter: Do not cease treatment abruptly.

Question 26

Why should ACE inhibitors be avoided in pregnant women?

Answer 26

ACE inhibitors can harm the developing fetus and are contraindicated during pregnancy.

Question 26

How does renal impairment affect the use of ACE inhibitors, and what risk should be monitored?

Answer 26

Renal impairment increases the risk of hyperkalaemia, which should be monitored when using ACE inhibitors.

Question 26

Why should ACE inhibitors be avoided in patients with renal artery stenosis?

Answer 26

ACE inhibitors can cause reduced renal blood flow, which may worsen renal artery stenosis.

Question 27

Why should Sartans be avoided in pregnant women?

Answer 27

Sartans can harm the developing fetus and are contraindicated during pregnancy, similar to ACE inhibitors.

Question 28

How does renal impairment affect the use of Sartans, and what risk should be monitored?

Answer 28

Renal impairment increases the risk of hyperkalaemia, which should be monitored when using Sartans.

Question 29

Why should Sartans be avoided in patients with renal artery stenosis?

Answer 29

Sartans can reduce renal blood flow and exacerbate renal artery stenosis.

Question 30

What is the recommendation regarding the use of thiazide diuretics in pregnant women?

Answer 30

Thiazide diuretics are not advised in pregnancy.

Question 30

How does renal impairment affect the use of thiazide diuretics, and why might they be less effective?

Answer 30

Thiazide diuretics are less effective in patients with renal impairments due to reduced glomerular filtration.

Question 31

For which condition are thiazide diuretics contraindicated, and what electrolyte imbalance should be monitored in diabetic patients?

Answer 31

Thiazide diuretics are contraindicated in anuria. They may lead to hyponatraemia in diabetic patients, which should be monitored.

Question 32

What comorbidity might make the use of thiazide diuretics inadvisable due to potential exacerbation?

Answer 32

Thiazide diuretics may aggravate gout, making them less suitable for individuals with this condition.

Question 33

What are some risk factors included in the Australian CVD risk assessment?

Answer 33

Risk factors included in the assessment typically comprise age, sex, smoking status, systolic blood pressure, and cholesterol levels.

Question 33

Why is diabetes not included as a risk factor in the Australian CVD risk assessment?

Answer 33

because it is already accounted for in the calculations of systolic blood pressure and cholesterol levels.

Question 34

How does the Australian CVD risk assessment account for comorbidities like diabetes?

Answer 34

The assessment indirectly considers diabetes by factoring in related risk factors, such as high blood pressure and cholesterol, which are more common in individuals with diabetes.

Question 35

Why are additional factors like family history and socioeconomic status not included in the Australian CVD risk assessment?

Answer 35

The assessment focuses on easily measurable and modifiable risk factors to provide a practical and scalable tool for estimating CVD risk.