Hypertension Flashcards
How is essential hypertension diagnosed?
Screening of asymptomatic individual
Define essential hypertension
blood pressure ≥140/90 mmHg with no secondary cause identified
What are RFs for essential hypertension?
Obesity Lack of exercise Alcohol intake DM Black ancestry >60 years FH
What investigations should be done for essential hypertension?
ECG
Fasting metabolic panel with eGFR
Lipid panel
Urinalysis
What is the conservative management for essential hypertension?
Lifestyle modification e.g. sodium reduction potassium rich diet DASH Maintain waist circumference Increase physical activity
What is the medical management for essential hypertension?
Thiazide diuretic
ACEi or Angiotensin-II-receptor antagonist
CCBs
What are some angiotensin-II-receptor antagonists?
Losartan
Irbesartan
What are some ACEi?
Ramipril
Lisinopril
What is the primary option for CCBs?
Amlodipine
What are some thiazide diuretics?
Indapmide
Bendroflumethiazide
What is the most common cause of secondary hypertension?
Conn’s syndrome
Primary hyperaldosteronism
What is the second most common cause of secondary hypertension?
Renal disease e.g. Glomerulonephritis Pyelonephritis Polycystic kidney disease Renal artery stenosis
What are other endocrine causes of secondary hypertension?
Phaeochromocytoma
Cushing’s
Acromegaly
What drugs can induce hypertension?
Steroids
COCP
NSAIDs
What are the presenting features of pulmonary hypertension?
SOB Tiredness Dizziness Angina Palpitations Oedema
What is idiopathic arterial pulmonary hypertension?
Disease of the small pulmonary arteries
Increases pulmonary vascular resistance
Leads to RV failure
Defined by pulmonary arterial pressure > 25mmHg at rest
Who commonly gets pulmonary arterial hypertension?
Females
20-50 years
What investigations are done for pulmonary arterial hypertension?
CXR - enlarged pulmonary artery, enlarged hilar vessels
ECG - evidence of RVH, right axis deviation
Transthoracic doppler echocardiography - estimates RVSP > 35mmHg
6 min walk test
Gold standard = Right heart catheterisation showing MAP > 25mmHg at rest
What is the management for pulmonary arterial hypertension?
CCB e.g. amlodipine
Lifestyle e.g. aerobic exercise, sodium restriction
What are causes of pulmonary hypertension?
Pulmonary arterial hypertension
Left sided heart conditions
Hypoxia
Clots in pulmonary arteries
What is the management for pulmonary hypertension?
Treat underlying cause
Anticoagulant
Diuretics if HF
