GP ILA's Flashcards
How does NICE define hypertension
-Clinic : >140/90
-Home : >135/85
Give the 3 stages of hypertension
-1 : >140/90
-2 : >160/100
-3 : >180/120
Give 4 causes of secondary hypertension
-ROPE
-R : Renal disease (most common)
-O : Obesity
-P : Pregnancy induced / pre-eclampsia
-E : Endocrine (e.g. hyperaldosteronism-Conns)
Give the medical management for HTN (<55, white)
-Step 1 : ACE
-Step 2 : ACE + CCB
-Step 3 : ACE + CCB + Thiazide-Like diuretic
-Step 4 : ACE + CCB + Diuretic (indapapamide) + Spironolactone (if K+ <4.5mmol) OR alpha or beta blocker (if potassium >4.5mmol)
Give the medical management of HTN (>55, black)
-Step 1 : CCB
-Step 2 : CCB + ARB or thiazide like diuretic
-Step 3 : CCB + ARB + Thiazide like diuretic
What is the first line management of HTN in someone with T2DM despite age or family origin ?
-ACE or ARB
What lifestyle advice can be given to someone with stage 1 HTN before medication is given ?
-Healthy diet
-Stop smoking
-Reduce alcohol, caffeine and salt intake
-Increase exercise
What investigations should all patients with a new diagnosis of HTN receive ?
-Urine albumin : creatine ratio for proteinuria
-Dipstick : for microscopic haematuria to assess kidney damage
-Bloods : HbA1c, renal function and lipids
-Fundus examination : for HTN retinopathy
-ECG : for cardiac abnormalities
Give 5 complications of HTN
-IHD
-Cerebrovascular accident (stroke, haemorrhage)
-Hypertensive retinopathy
-Hypertensive nephropathy
-Heart failure
Give 3 complications of ACEI’s
-Cough
-Angioedema
-Hyperkalaemia
Give 2 examples of an angiotensin II receptor blocker (ARB)
-Candesartan
-Losartan
Give 5 SE of beta blockers
-Erectile dysfunction
-Bronchospasm
-Cold peripheries
-Fatigue
-Sleep disturbance
Give 3 SE of CCB
-Constipation
-Flushing
-Ankle swelling
-Dizziness/Headache
Give a side of an ARB
-Hyperkalaemia
Give 3 SE of thiazide-like diuretics
-Hyponatraemia
-Hypokalaemia
-Dehydration
Give HTN treatment targets
<80yrs : <140/90
>80 years : <150/90