Hypertension Flashcards
What blood pressure reading would need an immediate SAME DAY specialist referal?
- Accelerated Hypertension (BP reading of 180/120mmHg) with signs of
1. papilloedema,
2. and/or retinal haemorrhage
3. or life-threatening symptoms, such as new-onset confusion, chest pain, signs of heart failure, or acute kidney injury.
4. suspected pheochromocytoma (for example labile or postural hypotension, headache, palpitations, pallor, abdominal pain, or diaphoresis).
What would be the appropriate course of action for someone who had a BP reading of 164/112mmhg after three readings in both arms?
Offer AMBPH and consider prescribing ti-hypertnesive medication immediately
What should AMBPH reading be under?
Under 135/85mmHG
What is the difference between primary hypertension and secondary hypertension?
Primary hypertension (which occurs in about 90% of people) has no identifiable cause. Secondary hypertension (about 10% of people) has a known underlying cause, such as renal, endocrine, or vascular disorder, or the use of certain drugs.
What should be done for patients under 40 years old with hypertension?
Consider specialist investiagtion to see secondary cause of hypertension
If a patient’s first blood pressure reading is equal to or above 140mmHg (systolic) or equal to or above 90mmHg (diastolic), what should be the next course of action?
The diagnosis is then confirmed with ABPM or HBPM.
- While waiting for confirmation of a diagnosis of hypertension, the person should be offered:
Investigations for target organ damage and for secondary causes of hypertension.
-Assessment of cardiovascular risk.
What are the different stages of hypertension?
Stage 1 hypertension: CBP = 140/90 or HBPM = 135/85
Stage 2: CBP = 160/100 or HBPM = 150/95
Stage 3: CBP = 180/120
What is accelerated (or malignant) hypertension?
A severe increase in blood pressure to 180/120 mmHg or higher (and often over 220/120 mmHg) with signs of retinal haemorrhage and/or papilloedema (swelling of the optic nerve).
What are the target clinic BP reading?
- Under 80 years old: CBP <140/90 or HBPM <135/85
- Over 80 years old: CBP <150/90 or HBPM <145/85
What is the best course of action if a patient’s BP reading is less than 140/90mmHg?
- No medication needed
- Check BP reading every 5 years
What is a normal BP reading?
120/80mmHg
What is the initial management for patients who have a BP reading of 140/90mmHg - 180/120mmHg?
- Offer HBPM
- Offer lifestyle advice
- Investigate end organ damage
- Calculate QRISK Score
When do you treat a patient that had a CBP of 140/90 and a HBPM reading of 135/85?
- Offer Lifestyle advice
- If they are under 80 years old with:
1. Target organ damge ( e.g. Left Ventricular Hyperthrophy, CKD, Retinopathy)
2. CVD
3. Renal Disease
4. Diabetes
5. QRISK Score of over 10% - If they are under 60 years old with with a QRISK Score under 10%
What lifestyle advice can be given about sodium consumption in patients with hypertension?
Dietary sodium — encourage people to keep their dietary sodium intake low, by reducing or substituting sodium salt, as this can reduce blood pressure.
Be aware that salt substitutes containing potassium chloride should not be used by older people, people with diabetes, pregnant women, people with kidney disease, and people taking some antihypertensive drugs (such as angiotensin converting enzyme inhibitors and angiotensin-II receptor blockers). Encourage salt reduction in these groups of people.
What is the next step of managment for stage 2 hypertension (CBP = 160/100mmHg, HBPM 150/95mmHg)
Offer antihypertensive drug treatment in addition to lifestyle advice to adults with persistent stage 2 hypertension, regardless of age.