Hypertension Flashcards
what is hypertension
elevated blood pressure in the arteries
causes
age, FH, lifestyle, secondary to conditions, stress
what conditions can cause hypertension
renal problems
CVS problems
endocrine conditions
what are the three stages of hypertension
1st: 140/90
2nd: 150/100
3rd: 160/110
when do you treat
stage 1, less than 80yrs old with CVS, end-organ damage or diabetes
always at stage 2
management
<55yrs: ACEI CCB thiazide diuretic alpha, beta blocker/spironolactone - check K levels or increase diuretic
>55yrs or African: CCB ACEI/ARB thiazide diuretic alpha, beta blocker/spironolactone - check K levels or increase diuretic
which BP value causes more concern
systolic
what management is used in a hypertensive crisis
give oral amlodipine
arrange ECG, CT
potential intra-cranial haemorrhage pathology - IV labetalol
when is a CCB as first line contradicted
presence of co-morbidities
what can be seen when starting ramipril
reduced eGFR and rise in sodium
rise in potassium
malignant hypertension
due to fibrotic necrosis
extremely elevated BP values
headache
visual problems
when is IV GTN preferred over IV labetalol
acute coronary syndrome background
what needs to be done if there highly elevated BP but no concerning symptoms
urgent investigations
if the patient is diabetic, how would you manage
ACEI/A2RB take priority
A2RB - african-caribeen
how do you know if you use spironolactone or alpha/beta blocker as 4th line management
K <4.5 - spironolactone
K>4.5 - alpha/beta blocker
