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year 1 week 18 - blood pressure/hypertension & clinical pharmacology > Hypertension > Flashcards

Hypertension Flashcards

1
Q

what is hypertension

A

blood pressure that is too high

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2
Q

what does blood pressure include

A

systolic and diastolic pressures

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3
Q

what is BP measured in

A

mmHg

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4
Q

BP measurement

A

clinic/surgery
24hr ambulatory
home/self
all - relax for 5mins - at least 3 readings - first assessment both arms
at least 3 readings over several weeks - should be away from clinical setting

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5
Q

CVD and risk factors - mainly refers to diseases affecting:

A

coronary heart disease
cerebrovascular diseases
other arterial diseases

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6
Q

coronary heart disease - risks for what diseases

A

MI
angina
sudden cardiac death
heart failure

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7
Q

cerebrovascular diseases - risks for what diseases

A

cerebrovascular attack - cva, stroke
transient ischaemic attack (TIA)
multi-infarct dementia

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8
Q

other arterial diseases - risks for what diseases

A

peripheral vascular disease
renal impairment, renal artery stenosis
abdominal aortic aneurysm (AAA)
retinopathy, papilledema

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9
Q

risk factors for atherosclerosis and CVD

A

hypertension
hyperglycaemia
kidney disease
dyslipidaemia
insulin resistance
obesity
poor fitness
family history of CVD
lifestyle risk factors - smoking, poor diet, poor sleep

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10
Q

CVD risk factors

A

age
elevated BP
elevated cholesterol
increased BMI
impaired glucose tolerance
decreased renal function

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11
Q

what does diagnosis of hypertension require

A

both conventional BP > 140/90
and ABPM/home BP >135/85

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12
Q

signs of hypertensive tissue damage

A

kidneys - urinalysis for proteinuria
heart - ecg, left ventricular hypertrophy
retina - fundoscopy, hypertensive retinopathy

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13
Q

treating hypertension

A

target people with highest sustained BP - grade 2 HT and/or TOD
and highest absolute risk - best to prioritise treatment in high risk groups
includes those with existing CVD, diabetes, chronic kidney disease, 10yr CVD risk

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14
Q

ACE inhibitors

A

inhibit angiotensin converting enzyme, block RAAS, increase bradykinin (vasodilator), dilate arteries and veins

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15
Q

ACE inhibitor side effects

A

cough, rise in or high K+, renal dysfunction

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16
Q

examples of ACE inhibitors

A

enalapril
lisinopril
ramipril

17
Q

angiotensin 2 receptor blockers

A

similar to ACE inhibitors, no BK effect

18
Q

angiotensin 2 receptor blocker side effects

A

few
rise in/high K+, renal dysfunction

19
Q

angiotensin 2 receptor blocker examples

A

losartan
candesartan

20
Q

calcium channel blockers

A

block voltage gated calcium channels, dilate arteries, sometimes heart rate reduction

21
Q

calcium channel blocker side effects

A

headaches, flushing, ankle swelling, tachycardia

22
Q

side effects of rate limiting calcium channel blockers

A

bradycardia, constipation, other GI symptoms

23
Q

examples of calcium channel blockers

A

nifedipine
amlodipine
rate limiting - verapamil, diltiazem

24
Q

diuretics

A

inhibit Na Cl symport, distal tubular natriuresis, dilate arteries and veins

25
Q

side effects of diuretics

A

impotence, rashes, biochemical - low Na+, low K+
raised glucose (risk of diabetes), high urate (risk of gout)

26
Q

examples of diuretics

A

bendroflumethiazide
chlortalidone
indapamide

27
Q

beta blockers

A

block β-adrenoceptors, reduce cardiac rate and output, block RAAS, initially vasoconstrict, ultimately vasodilate

28
Q

side effects of beta blockers

A

wheeze (caution with asthma/copd), cold peripheries, lassitude, exercise intolerance, impotence, bradycardia, heart block, raised glucose

29
Q

examples of beta blockers

A

atenolol
metoprolol
bisoprolol

30
Q

mineral corticoid blockers

A

block mineral corticoid receptors, distal nephron natriuresis/limit potassium loss
potassium sparing diuretics

31
Q

side effects of MC blockers

A

rise in/high K+, gynaecomastia (with spironolactone)

32
Q

examples of MC blockers

A

spironolactone
eplerenone

33
Q

alpha blockers

A

block ⍺1-adrenoceptors, dilate arteries and veins

34
Q

side effects of alpha blockers

A

dizziness, especially on standing
urinary symptoms
tachycardia
oedema

35
Q

examples of alpha blockers

A

doxazosin

36
Q

reasons for treatment failure

A

poor adherence
ineffective combinations
other drugs e.g. NSAIDs
inappropriately low doses
secondary causes

37
Q

primary and secondary cause percentage

A

~95% primary
~5% secondary

38
Q

environmental causes of hypertension

A

body weight - obesity
physical inactivity
excess calorie intake
salt - high sodium, low potassium, low magnesium
excess alcohol
stress
diet rich in grains, veg, low saturated fat

39
Q

genetic causes of hypertension

A

30-50% genetic heritability
twins
association
genome wide linkage
genome wide association studies not finding genes of major effect

year 1 week 18 - blood pressure/hypertension & clinical pharmacology (7 decks)

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