Hypertension

Question 1

Definition

Answer 1

High or raised blood pressure >140/90

Can’t diagnose hypertension unless the blood pressure has been high or raised for at least 3 months

Question 2

Aetiology

Answer 2

Primary hypertension (95%):
– develops gradually over many years and is caused by atherosclerosis

Secondary hypertension (5%):
– caused by an underlying condition, tends to appear suddenly and cause higher blood pressure than primary hypertension:
—- adrenal gland tumours
—- blood vessel problems present at brith (congenital heart defects)
—- illegal drugs, such as cocaine and amphetamines
—- kidney disease
—- cuhsings syndrome
—- hyperthyroidism
—- hyperparathyroidism

Malignant hypertension (rare-1% of cases):
– rapid increase in blood pressure
– diastolic pressure can rise about 130
– life threatening- medical emergency

Question 3

Epidemiology

Answer 3

Risk of hypertension increases as you get older

Question 4

Risk factors

Answer 4

Age

Gender- up to 64 its more common in med, 65+ its more common in women

Race- more common in black people

Family history

Obesity or being overweight

Lack of exercise

Too much salt

Low potassium levels

Stress

Drinking too much

Pregnancy

Question 5

Pathophysiology (its changes?)

Answer 5

Early hypertension:
– plagues just start to build up on the arterial wall, blood pressure may not be as high at this point as the arteries haven’t narrowed a lot

Late hypretension:
– more plaque build up with the artery and hypertrophy of the arterial wall, causes the artery to narrow even more meaning in late hypertension there will be a higher blood pressure

End organ damage:
– hypertension can eventually lead to end organ failure:
—- stroke
—- retinopathy
—- TIA
—- left ventricular hypertrophy
—- cardiac failure
—- renal failure

Stages of hypertension:
- optimal- 120/80
- pre hypertension- 120-139/80-99
- stage 1 hypertension- 140-159/90-99
- stage 2 hypertension- >160/>100

Question 6

Clinical presentation

Answer 6

Hypertension is generally asymptomatic

Secondary causes of hypertension may be suggested by specific features:
– attacks of sweating
– tachycardia

Headache

Dyspnoea (shortness of breath)

Retinopathy visual changes

Chest pain

Sensory or motor problems

Nosebleeds

May suffer with end organ damage if the hypertension is untreated and severe