Hypertension Flashcards
What is the definition of hypertension?
Persistently raised arterial blood pressure- measured in 2 readings (systole/ heart contracts + diastole/ heart relaxes)
What is the difference between primary or secondary hypertension?
Primary hypertension - diagnosed without a known cause 90%
Secondary hypertension-
diagnosed with a known secondary cause - 10%
What is the clinic reading measurements for BP?
Stage 1 - 140/90 mmHg
Stage 2 - 160/100 mmHg
Stage 3 - 180/120 mmHg
What are the readings when measuring HBPM/ABPM?
Stage 1 HTN - 135/85
Stage 2 HTN - 150-95
Stage 3 HTN - 180/120
What are the secondary causes of HTN? (Vascular disorders)
Renal artery stenosis (narrowing of 1 or more arteries that carry blood to the kidneys)
Aorta coarctation - constriction of the aorta
What are the secondary causes of HTN? (Renal disorders)
Chronic kidney disease (gradual loss of kidney function)
Diabetic nephropathy (kidney damage caused by diabetes)
What are the secondary causes of HTN? (Endocrine disorders)
Cushing’s syndrome (caused by too much cortisol in the body)
Hypothyroidism (thyroid gland does not produce enough hormones)
What are the risk factors of HTN?
Age - BP rises with age
Gender - up to 65 - women have higher BP/ between 65-74 men have a higher BP
Ethnicity- black African or black Caribbean
Lifestyle factors
Emotional stress and anxiety
Complications of HTN
Heart failure
Coronary artery disease
Peripheral arterial disease
Stroke
Chronic kidney disease
Diagnosis
Measure BP in both arms/ different reading 15mmHG/ repeat test + use the highest reading
BP higher than 140/90 -repeat - use lower of the last 2 readings
ABPM - Between 140/90 + 180/120 mmHg - offer ambulatory blood pressure monitoring - waking hours 2 measurements taken per hour / average value of at least 14 measurements
HBPM- 2 daily - 4-7 days twice daily
Above 180/120 mmHg - same day specialist referral
What are symptoms of hypertension?
headaches/ dizziness/ palpitations/ SOB/ fatigue/ nausea/ vision changes
Investigations of HTN
BP monitoring
Assessing for target organ damage - test for haematuria (ECG - access for cardiac function/ urine test/ ACR (urine test KF ratio albumin: creatinine), U+E’s (urea + electrolytes BT) which include creatinine, eGFR (test to see how well kidneys are filtering), HbA1C (test for diabetes)
assess QRISK score estimate of risk of heart attack or stroke
What is the management for patients with stage 4 HTN?
Refer to the specialist assessment of target organ damage
What medication is used to treat hypertension?
Combination of medication - under 55 years - ACE (reduce blood pressure) inhibitor - ramipril or ARB
55 or older/ African or Caribbean - CCB
Beta blockers - bisoprolol
