Hypertension

Question 1

What is Stage 1 hypertension

Answer 1

BP of 140/90
ABPM daytime average of 135/85

Question 2

What is stage 2 hypertension?

Answer 2

160/100 BP
ABPM daytime average 150/95

Question 3

Stage 3/severe/malignant hypertension

Answer 3

180/120

Question 4

What is secondary hypertension

Answer 4

Hypertension with a cause

10-20% of cases

• renal issues
• endocrine issues - Cushing or conn’s

Patients u40 yrs should be seen by specialist

Question 5

What increases risk of hypertension

Answer 5

Male (risk double)
Cig Smoke
Renal
Diabetes
Previous stoke/MI
Hyperlipidaemia
LV hypertrophy (risk double)

Question 6

Renin Angiotensin-Aldosterone System (RAAS)

Answer 6

Important in BP control

Maintains sodium’s balance, BV control and BP control

Question 7

What is the RAAS stimulated by?

Answer 7

Fall in BP
Fall in circulating volume
Sodium depletion

Any of these leads to release of renin from juxtaglomerular apparatus

Question 8

What does renin do?

Answer 8

Converts angiotensin to angiotensin 1 which is converted to angiotensin II by ACE

Angiotensin II is a potent vasoconstrictor and stimulates the release of aldosterone from the adrenal glands whihc leads to sodium retention

This leads to BP increasing

Question 9

Stage 1 hypertension treatment if u55?

Answer 9

ACE inhibitor

Question 10

Stage 1 treatment if over 55 or black or fertile woman

Answer 10

CCB or thiazide diuretic

If they have complications such as diabetes

Give ACEi if complications in PMH

Question 11

Second step of hypertension treatment

Answer 11

Add thiazide diuretic

Question 12

Step 3 of hypertension treatment

Answer 12

Add CCB, ACEi and Diuretic together

Question 13

Step 4 of hypertension

Answer 13

Low dose spironolactone

Question 14

Pre eclampsia treat with

Answer 14

IV magnesium sulphate with IV labetalol/Hydralazine/Methyldopa