Hypertension

Question 1

What is systolic and diastolic pressure?

Answer 1

Systolic - pressure of blood when heart beats and forces it around the body
Diastolic - pressure of blood when heart is at rest between each beat

Question 2

What lifestyle advice would you give to a patient with hypertension?

Answer 2

1. Alcohol - <14units a week
2. Reduce salt intake to <100mmol/day
3. Smoking cessation
4. Increase fruit/veg/low-fat dairy/low saturated fats
5. Min. 150mins exercise a week, or 75mins vigorous exercise spread out throughout the week
6. Maintain BMI

Question 3

What would you do if a patients BP is <140/90mmHg?

Answer 3

Recheck BP every 5 years

Question 4

When do you offer a patient ABPM or HBPM?

Answer 4

If a patients BP is 140/90mmHg - 179/119mmHg

Question 5

What should you do if a patients BP is >180/120mmHg?

Answer 5

REFER

Question 6

What are the blood pressure targets for a type 1, and a type 2 diabetic?

Answer 6

Type 1 - <135/85mmHg
Type 2 - <140/90mmHg

Question 7

What is the treatment for someone with stage 1 hypertension?

Answer 7

135/85 - 149/94mmHg

Offer lifestyle advice +/- drug treatment

Question 8

What is the treatment for stage 2 hypertension?

Answer 8

> 180/95mmHg

Lifestyle advice + must start drug treatment

Question 9

What is the treatment for patients who either have T2DM, or does not have T2DM but is <55yrs & is of non-black origin?

Answer 9

Step 1 - ACEi or ARB
Step 2 - (ACEi or ARB) + (CCB or thiazide-like diuretic)
Step 3 - (ACEi or ARB) + CCB + thiazide-like diuretic)
STEP 4 (specialist) - Spironolactone, or alpha blocker, or b-blocker

Question 10

What is the treatment for patients who don’t have T2DM, but are either >55yrs or have black origins?

Answer 10

Step 1 - CCB
Step 2 - CCB + (ACEi or ARB or thiazide-like diuretic)
Step 3 - (ACEi or ARB) + CCB + thiazide-like diuretic
Step 4 (specialist) - Spironolactone, or alpha blocker, or b-blocker

Question 11

What is the treatment for patients who don’t have T2DM, but are either >55yrs or have black origins?

Answer 11

Step 1 - CCB
Step 2 - CCB + (ACEi or ARB or thiazide-like diuretic)
Step 3 - (ACEi or ARB) + CCB + thiazide-like diuretic
Step 4 (specialist) - Spironolactone, or alpha blocker, or b-blocker

Question 12

What are some examples of ACEi, CCBs, diuretics, and ARBS?

Answer 12

ACEi - ramipril, lisinopril, perindopril
CCBs - diltiazem, amlodipine
Diuretics - indapamide
ARBs - candesartan, valsartan, losartan

Question 13

What are some alpha and b-blockers which are used to treat blood pressure?

Answer 13

Alpha blockers - doxazosin
Beta blockers - atenolol, metoprolol, bisoprolol