Final Exam - Hypertension Flashcards
What is the target blood pressure for patients who require blood pressure-lowering therapy?
The target is to reduce blood pressure to <140/90mmHg.
What is considered the normal blood pressure target for individuals without hypertension?
Target is typically 120/80mmHg.
What is one key rationale for using certain medications in the management of cardiovascular conditions, such as hypertension and heart disease?
Is to reduce premature cardiovascular morbidity and mortality.
Apart from cardiovascular benefits, what other potential rationale is associated with drug use in managing conditions like diabetes?
Medications may help reduce microvascular disease affecting organs like the brain, kidney, and retinas.
In the context of managing hypertension, what is another significant rationale for using antihypertensive drugs?
To reduce blood pressure, thereby lowering the risk of cardiovascular complications.
When determining the appropriate timing to commence blood pressure treatment, what factors should be taken into consideration besides blood pressure levels?
It depends on whether patients have other risk factors such as diabetes, dyslipidemia, family history, and smoking, among others.
What overarching consideration is important when deciding when to initiate blood pressure treatment?
Patient’s overall cardiovascular risk, not just their blood pressure readings.
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?
The appropriate blood pressure target for the specific patient, taking into account their unique risk factors and medical history.
How can weight reduction benefit individuals with hypertension if they are overweight?
Weight loss reduces the workload on the heart and lowers blood pressure.
Why is maintaining physical activity an important non-pharmacological approach to managing hypertension?
Regular physical activity helps improve cardiovascular health and lower blood pressure.
What type of dietary plan is recommended for individuals looking to control hypertension through non-pharmacological means?
A healthy eating plan, such as the DASH diet (Dietary Approaches to Stop Hypertension), is often recommended.
How can smoking cessation contribute to the management of hypertension?
Quitting smoking reduces the risk of cardiovascular complications and helps lower blood pressure.
Besides reducing alcohol intake, what dietary approach can help manage hypertension through non-pharmacological methods?
Adopting a Mediterranean-style diet, rich in fruits, vegetables, and whole grains, can be beneficial for hypertension.
What dietary component should individuals reduce their intake of to support hypertension management non-pharmacologically?
Reduce their intake of saturated fatty acids, often found in high-fat animal products.
What is the abbreviated name for drugs in the ACE-I class, which are commonly used in the treatment of hypertension?
ACE-I stands for Angiotensin-Converting Enzyme Inhibitors.
Which class of antihypertensive medications includes drugs like candesartan and irbesartan?
Sartans or Angiotensin II Receptor Blockers (ARBs) class.
What is the role of calcium channel blocking agents in managing hypertension pharmacologically?
Help relax blood vessels, leading to reduced blood pressure.
Besides ACE inhibitors and sartans, what is one class of antihypertensive medications commonly used in the treatment of hypertension?
Thiazide diuretics are another common class of antihypertensive medications.
What is the mechanism of action of ACE inhibitors such as perindopril and lisinopril in treating hypertension?
They reduce the conversion of angiotensin I to angiotensin II, leading to reduced vasoconstriction and sodium/water retention.
Name a common adverse effect of ACE inhibitors, and what monitoring parameters are essential when using these drugs?
Cough
Monitoring parameters: Review the use of NSAIDs (if applicable), start with a low dose, and monitor renal function before and after starting.
How do sartans like candesartan and irbesartan work to lower blood pressure?
Sartans prevent the binding of angiotensin II to type 1 angiotensin receptors, reducing vasoconstriction, aldosterone release, and sodium/water retention.
Mention an adverse effect of sartans, and what monitoring parameters should be considered when using these medications?
Adverse effect: Dizziness
Monitoring parameters: Review the use of NSAIDs (if applicable) and monitor renal functions before and after starting.
List two adverse effects of thiazide diuretics, and what monitoring parameters should be in place when patients are prescribed these drugs?
Adverse effects: Electrolyte disturbances and hyperuricaemia (gout), Hyperglycaemia (diabetes)
Monitoring parameters: Review the use of NSAIDs.
What is the mechanism of action of thiazide diuretics, like hydrochlorothiazide, in managing hypertension?
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.
How do calcium channel blocking agents like amlodipine and diltiazem contribute to blood pressure reduction?
They block the inward flow of calcium into cells in vascular smooth muscles and the heart, causing vasodilation and reducing peripheral vascular resistance.
Name an adverse effect of calcium channel blocking agents and a monitoring parameter for these medications.
Adverse effect: Peripheral edema
Monitoring parameter: N/A
What is the primary mechanism of action for beta-blockers like metoprolol and atenolol in hypertension management?
Beta-blockers block beta receptors in the body, reducing blood pressure and heart rate.
Why are beta-blockers not recommended as first-line agents for uncomplicated hypertension? Mention one adverse effect and a monitoring parameter for these drugs.
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.
Why should ACE inhibitors be avoided in pregnant women?
ACE inhibitors can harm the developing fetus and are contraindicated during pregnancy.
How does renal impairment affect the use of ACE inhibitors, and what risk should be monitored?
Renal impairment increases the risk of hyperkalaemia, which should be monitored when using ACE inhibitors.
Why should ACE inhibitors be avoided in patients with renal artery stenosis?
ACE inhibitors can cause reduced renal blood flow, which may worsen renal artery stenosis.
Why should Sartans be avoided in pregnant women?
Sartans can harm the developing fetus and are contraindicated during pregnancy, similar to ACE inhibitors.
How does renal impairment affect the use of Sartans, and what risk should be monitored?
Renal impairment increases the risk of hyperkalaemia, which should be monitored when using Sartans.
Why should Sartans be avoided in patients with renal artery stenosis?
Sartans can reduce renal blood flow and exacerbate renal artery stenosis.
What is the recommendation regarding the use of thiazide diuretics in pregnant women?
Thiazide diuretics are not advised in pregnancy.
How does renal impairment affect the use of thiazide diuretics, and why might they be less effective?
Thiazide diuretics are less effective in patients with renal impairments due to reduced glomerular filtration.
For which condition are thiazide diuretics contraindicated, and what electrolyte imbalance should be monitored in diabetic patients?
Thiazide diuretics are contraindicated in anuria. They may lead to hyponatraemia in diabetic patients, which should be monitored.
What comorbidity might make the use of thiazide diuretics inadvisable due to potential exacerbation?
Thiazide diuretics may aggravate gout, making them less suitable for individuals with this condition.
What are some risk factors included in the Australian CVD risk assessment?
Risk factors included in the assessment typically comprise age, sex, smoking status, systolic blood pressure, and cholesterol levels.
Why is diabetes not included as a risk factor in the Australian CVD risk assessment?
because it is already accounted for in the calculations of systolic blood pressure and cholesterol levels.
How does the Australian CVD risk assessment account for comorbidities like diabetes?
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.
Why are additional factors like family history and socioeconomic status not included in the Australian CVD risk assessment?
The assessment focuses on easily measurable and modifiable risk factors to provide a practical and scalable tool for estimating CVD risk.
