Hypertension Flashcards
What is normal BP?
120/80
What is stage 1 HTN?
140/90
What is stage 2 HTN?
160/100
What is stage 3 HTN?
180/120
What are the risk factors?
Smoking
Diabetes
Renal disease
Male
Hyperlipidaemia
Previous MI/stroke
Low fitness
Age
Weight
Alcohol intake
Race
What % of HTN is primary?
80-90%
What % of HTN is secondary?
10-20%
What are the causes of secondary HTN?
Renal disease
Drug induced
Pregnancy
Endocrine
Vascular
Sleep apnoea
Obesity
What factors control BP?
Cardiac output
Stroke volume
Heart rate
What 2 systems are important for BP control?
Sympathetic nervous system
Renin- angiotensin- aldosterone (RAAS) system
How does the SNS control BP?
Vasoconstriction
Reflex tachycardia
Renin release
How does RAAS control BP?
Angiotensin II produced which causes vasoconstriction and water retention:
- Maintenance of sodium balance
- Control of blood volume
- Control of BP
What is hypertensive urgency?
> 180/20
No acute organ damage
What is hypertensive emergency?
> 180/120
Acute organ damage
What is the management of hypertensive emergency?
Lower systolic BP slowly
What is orthostatic HTN?
Decrease of 20 systolic or 10 systolic within 3 minutes of standing
What is the treatment for orthostatic HTN?
Heel rises
Isometric hand grips
Tilt bed at night
What are the types of HTN in pregnancy?
Chronic- existing
Gestational- develops in pregnancy
Preeclampsia- >140/90 and proteinuria
What drugs are used to treat HTN?
ACEIs/ARBs- ramipril/ losartan
Beta blocker- bisoprolol
CCBs- amlodipine
Thiazide like diuretics- indapamide
What is the treatment for >55?
- CCB
- Thiazide diuretic
- ACEI
- Beta blocker
What is the treatment for <55?
- ACEI
- Thiazide diuretic
- CCB
- Beta blocker
What less common agents can be used for treatment?
a-adrenoreceptor antagonists - doxazosin
Centrally acting agents- methyldopa
Vasodilators- hydralazine
