Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Year 1-Cardiovascular System > Hypertension > Flashcards

Hypertension Flashcards

1
Q

Define hypertension

A

Blood pressure at which the benefits of treatment with antihypertensive agents in reducing cardiovascular, cerebrovascular and peripheral vascular risk outweighs the risk of treatment.

wordy but just read it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What BP indicates a person has hypertension?

A

140/90

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What increase in BP doubles a persons risk of CVD death, regardless of age?

A

An increase in BP of 20mmHg systolic and 10 mmHg diastolic above ideal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Does BP stay fairly steady throughout the day?

A

No, it fluctuates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What can contribute to hypertension?

A

Physical stress
Mental stress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

When is BP classified as stage 1 hypertension?

A

Clinic BP 140/90 or higher
ABPM daytime average 135/85 mmHg or higher

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When is BP classified as being stage 2 hypertension?

A

Clinic BP 160/100 or higher
ABPM daytime average 150/95 mmHg or higher

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

When is BP classified as being stage 3 hypertension?

A

Clinic systolic BP 180/120mmHg or higher

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the most reliable measurement of BP?

A

ABPM as gets 30 readings a day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What % of cases are primary hypertension with no cause?

A

80-90%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are some of the causes of secondary hypertension?

A

Chronic renal disease
Renal artery stenosis
Endocrine disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Is secondary hypertension more common in older or younger patients?

A

Younger

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

If a patient <40 has hypertension, what should be done?

A

They should be referred to a specialist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are some of the risk factors for hypertension?

A

Smoking
Diabetes
Renal disease
Male
Hyperlipidaemia
Previous storke/MI
LV hyperterphophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Those with diabetes are how much more at risk?

A

5-30 x more risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Males are how many times more at risk?

A

2x

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

If an individual have LV hypertrophy, how much greater is their risk?

A

2x

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the primary contributors to BP?

A

Cardiac output (SV x HR)
Peripheral vascular resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the three things the sympathetic NS can cause to happen?

A
  1. Vasocontraction
  2. Reflex tachycardia
  3. Increased SV
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What does the SNS cause to release?

A

Renin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What does the release of renin in turn release?

A

Angiotensin 1 and 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the role of angiotensin 2?

A

Is a vasoconstrictor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What does aldosterone do?

A

Causes salt and water retention which increases the circulating blood volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is RAAS essential for?

-renin angiotensin-aldosterone system

A

Maintenance of sodium balance
Control of blood volume
Control of Blood pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the RAAS stimulated by?

A

Depletion of sodium
Fall in BP
Fall in circulating volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Where is renin released from?

A

Juxtaglomerular apparatus

27
Q

What does renin do?

A

Converts angiotensinogen to angiotensin 1

28
Q

What converts angiotensin 1 to angiotensin 2?

A

Angiotensin converting enzyme (ACE)

29
Q

What does angiotensin 2 stimulate the release of?

A

Aldosterone from the adrenal glands

30
Q

What are the two subdivisions of causes of hypertension?

A

Polygenic
Polyfactorial

31
Q

What are some of the factors which can contribute to hypertension?

A

Age
Genetics and family history
Environment
Weight
Alcohol Intake
Race

32
Q

Describe how age can affect BP

A

BP increases w age

33
Q

Describe how genetics and family history affect BP?

A

Hypertension tends to run in families.

->more in siblings than parents!

34
Q

How does the environment affect BP?

A

Physical and mental stress

35
Q

Does removing stress lower BP?

A

Not necessarily

36
Q

What is one of the most common causes of hypertension in young men?

A

Alcohol

37
Q

What do small amounts of alcohol do to BP?

A

Reduces it

38
Q

What do large amounts of alcohol do to BP?

A

Increase it

39
Q

Describe which weight changes can positively affect BP.

A

Weight loss of 9kg has been reported to produce a fall in BP of 19/18mmHg

40
Q

Describe how a long birth weight can increase BP.

A

For each kg underweight, systolic BP is 1-2mmHg lower

41
Q

Which race tend to have higher BP’s?

A

African

42
Q

How can you assess end organ damage?

A

ECG
Echocardiogram
Proteinuria
Renal ultrasound
Renal function

43
Q

What are some of the treatable causes of hypertension?

A

Obesity
Renal artery stenosis/ fibromuscular dysplasia
Endocrine causes
Coarctation of aorta
Drug induced
Sleep apnoea

44
Q

How do you quantify a patient’s risk of CVD?

A

Assign risk calculator/Q risk

45
Q

What is the starting goal of treatment?

A

Reduce risks by 10% over 10 years

46
Q

For those with stage 1 hypertension what is the treatment if the patient-

Is <80 and has at least one of the following-
Target end organ damage
Established cardiovascular disease
Renal disease
Diabetes
10 year CV risk 10% or greater

A

Antihypertensive drugs

47
Q

What do you offer elderly patients with stage 1 hypertension?

A

Offer the same antihypertensive drug treatment but BP target of 145/85

48
Q

What is the treatment for anyone with stage 2 hypertension?

A

Antihypertensive drugs

49
Q

Which treatment would you consider giving a patient who is over 55 or Black people of African/Caribbean descent?

A

Start a calcium channel blocker or a thiazide like diuretic

50
Q

Which treatment would you offer someone <55?

A

Offer ACE inhibitor or ARB

51
Q

Who <55 would you not offer ACE or ARB and why?

A

African or Caribbean – less effective and higher risk of angioedema
Women of child bearing age – teratogenic in early stages and fetal toxic in later stages

52
Q

What is step 2 in hypertension treatment after initial treatment?

A

Add Thiazide type diuretic to step 1

53
Q

What is step 3 in hypertension treatment?

A

Add CCB, ACEi and diuretic together

54
Q

When does a patient have resistant hypertension?

A

When they start stage 4 of treatment

55
Q

Give some examples of ACE inhibitors.

A

Ramipril, perindropril

all end in pril

56
Q

When would you not give someone ACE?

A

Renal artery stenosis
Impaired renal function
Hyperkalaemia
Fertile Female

57
Q

What do ARBS do?

A

Competitively inhibit the action of angiotensin II at the angiotensin AT1 receptor

58
Q

Which has fewer side effects- ACEi or ARBS?

A

ACEi

59
Q

Give examples of calcium channel blockers.

A

Amlodipine, felodipine

end in dipine

60
Q

If someone has an adverse drug reaction to calcium channel blockers, what can happen?

A

Flushing
Headache
Ankle oedema
Indigestion/reflux

61
Q

Who would not be given calcium channel blockers?

A

If someone had had any of the following-
Acute MI
Heart failure
Bradycardia (rate limiting CCBs)

62
Q

What is usually the first line therapy in mild-mod hypertension in people of African/Caribbean origin?

A

Thiazide Type Diuretics

63
Q

What are the mechanisms of action for thiazide type diuretics?

A

Enhance Urinary excretion of sodium
Resistance vessel dilation – reduce peripheral vascular resistance
Full antihypertensive effect may take weeks
Adverse drug reactions are not common but include gout and ED

64
Q

What is white coat hypertension?

A

BP only raised when taken by a doctor or a nurse

Year 1-Cardiovascular System (41 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions