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Cardiology > Hypertension > Flashcards

Hypertension Flashcards

1
Q

What is hypertension?

A

Blood pressure above which the benefits of treatment outweigh the risks in terms of morbidity and mortality

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2
Q

What is classed as a hypertensive blood pressure?

A

140/90mmHg

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3
Q

What are the two types of hypertension?

A

Primary/essential
Secondary

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4
Q

How many stages of hypertension are there?

A

Three

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5
Q

Whart blood pressure readings are classed as stage 1 hypertension?

A

Clinic BP- 140/90mmHg
ABPM-135/85mmHg

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6
Q

Whart blood pressure readings are classed as stage 2 hypertension?

A

Clinic BP- 160/100mmHg
ABPM-150/95mmHg

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7
Q

Whart blood pressure readings are classed as stage 3 hypertension?

A

180/110mmHg

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8
Q

What are the secondary causes of Hypertension?

A

R-Renal disease
O-Obesity
P-Pregnancy
E-Endocrine

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9
Q

If the blood pressure is very high or not responding to treatment in someone with renal disease, what should you consider?

A

Renal artery stenosis

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10
Q

What is the most common endocrine cause of high blood pressure?

A

Hyperaldosteronism

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11
Q

What are possible complications of hypertension?

A
  • Ischaemic heart disease
  • Cerebrovascular accident (i.e. stroke or haemorrhage)
  • Hypertensive retinopathy
  • Hypertensive nephropathy
  • Heart failure
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12
Q

How should blood pressure be measured when considering a diagnosis of hypertension?

A

Should be measured in both arms

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13
Q

When should you repeat blood pressure monitoring?

A
  • The difference in readings between arms is more than 20 mmHg
  • if the first reading is > 140/90 mmHg.
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14
Q

What is a possible pathological cause of blood pressure readings being different in two arms?

A

supravalvular aortic stenosis.

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15
Q

What are the main drug causes of hypertension?

A

NSAID’s
Steroids

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16
Q

What are the main cardiovascular causes of hypertension?

A

Sleep apnoea
Coarctation of the aorta

17
Q

What are lifestyle changes for the management of hypertension?

A

healthy diet,
Stopping smoking
Reducing alcohol
Caffeine and salt intake
Taking regular exercise.

18
Q

What classification of hypertension are given mendication?

A

Stage 2 hyoertension

19
Q

Which patients with stage1 hypertension are given medication?

A

Q-risk score of 10% or more, diabetes, renal disease, cardiovascular disease or end organ damage.

20
Q

Which medications are used in the management of hypertension?

A

A – ACE inhibitor
B – Beta blocker
C – Calcium channel blocker
D – Thiazide-like diuretic
ARB – Angiotensin II receptor blocker

21
Q

What is step 1 in the management of hypertension?

A

Aged less than 55 and non-black use A.
Aged over 55 or black of African or African-Caribbean descent use C.

22
Q

What is step 2 in the management of hypertension?

A

A + C.
Alternatively A + D or C + D.
If black then use an ARB instead of A.

23
Q

What is step 3 in the management of hypertension?

A

A + C + D

24
Q

What is step 4 in the management of hypertension?

A

A + C + D + additional

25
Q

What additional drugs can be given in step 4 of the management of hypertension?

A

Potassium sparing diuretic (spironolactone
Alpha blocker (doxazosin) or a beta blocker (atenolol).)

26
Q

When would a potassium sparing diuretic be used in the fourth step of the management of hypertension?

A

If the serum potassium is less than or equal to 4.5 mmol/l

27
Q

When would a potassium sparing diuretic not be used in the fourth step of the management of hypertension?

A

If the serum potassium is more than 4.5 mmol/l

28
Q

When would ARB’s be used rather than ACEi in the management of hypertension?

A

Patient is black of African or African-Caribbean descent

29
Q

What investigations might you consider doing for end organ damage?

A
  • Urine albumin: creatinine ratio for proteinuria and dipstick for microscopic haematuria- kidney damage
  • Bloods for HbA1c, renal function and lipids
  • Fundus- hypertensive retinopathy
  • ECG -cardiac abnormalities

Cardiology (66 decks)

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