Hypertension Flashcards
What is hypertension?
Raised blood pressure
What would be an expected reading of someone with hypertension?
Equal to or above 140/90
How should blood pressure be measured?
Three separate measurements should be taken in succession, separated by at least 1 minute. This should be carried out whilst sitting and rested. The average of the three measurements should be used as the reading.
What is ambulatory measuring?
Measuring blood pressure at regular intervals over a 24 hour period while patients undergo normal daily activities, including sleep.
Which ethnic groups are at higher risk of developing hypertension?
African, Caribbean and south Asian ethnicities
Why might African, Caribbean and south Asian ethnicities be at higher risk to hypertension?
Along with genetic factors, environmental factors such as the foods traditionally eaten - which tend to be higher in salt and saturated fat- put these groups at higher risk of hypertension
The treatment of hypertension has what effect on patients risk of coronary heart disease?
It has little effect, coronary heart disease - which eventually causes patient to have a heart attack- is a slow, long process. So, treatment of hypertension will not reverse atherosclerotic pressure built up in blood vessels.
What is another name for coronary heart disease?
Atherosclerosis
The treatment of hypertension has what effect on the outcome of heart failure?
Significant improvement in risk of heart failure, as reduces workload of heart, making muscle more able to cope
What are the two common disease outcomes of hypertension?
- accelerated atherosclerosis
- renal failure
What can be the consequence of accelerated atherosclerosis?
- myocardial infarction
- stroke
- peripheral vascular disease
What is “essential” hypertension?
When blood pressure is abnormally high, however not as a result of a medical condition. This is likely a genetic failure of auto-regulation control of blood vessel wall constriction.
What is renal artery stenosis?
The narrowing of one or more arteries that carry blood to your kidneys
What are the three hormones that endocrine tumours release which can be rare triggers for hypertension?
- Adrenaline
- Aldosterone
- Cortisol
What is the role of adrenaline, related to hypertension?
Acts as a vasoconstrictor
What is the role of aldosterone and cortisol, relating to hypertension?
They increase circulating blood volume
What neuroendocrine, adrenergic tumour may release adrenaline, in turn causing high blood pressure?
Phaeochromocytoma
What syndrome is characterised by excess aldosterone production?
Conn’s syndrome
What syndrome is a result of excess cortisol in the body over a long period of time?
Cushing’s syndrome
What symptom is more common in malignant hypertension- where blood pressure is rapidly accelerating?
Headache
What is a transient ischaemic attack?
Also known as a “mini stroke”, it is a serious condition where the blood supply to the brain is temporarily disrupted
Where is the adrenal gland situated?
Just above the renal gland, within the region of the kidney.
True or false?
Phaeochromocytoma is a renal disease.
False, it is an adrenergic tumour. The adrenal gland sits above the renal gland. It is in the region of the kidney but it is nit a renal disease.
Why is swelling a symptom of Cushing’s syndrome?
This syndrome results in salt/water retention, which leads to excess fluid within the circulation
What is hypovolemia?
A condition where your body loses fluid, like blood or water
What are the 4 investigations for hypertension?
- Urinalysis
- Serum biochemistry
- Serum lipids
- ECG
What blood pressure is aimed for as a result of hypertension treatment?
BP < 120/90 mmHg
What are the four most common drug types used to treat hypertension?
- Thiazide diuretic
- Beta blocker
- Calcium channel antagonist
- ACE inhibitor
What is an example of a thiazide diuretic?
Dendroflumethiozide
what is an example of a beta blocker?
Atenalol
What is the side effect commonly associated with thiazide diuretic’s?
Gout (sudden swelling and severe pain in joints)
What is the side effect commonly associated with beta blockers?
COPD & asthma
What is the side effect commonly associated with calcium channel antagonist?
Gingival hyperplasia
What is the side effect commonly associated with ACE inhibitors?
Peripheral vascular disease
How often would you monitor someone with stable control of hypertension?
Annually
How often would you monitor someone with unstable control of hypertension?
Every 2-3 months
What group of drugs particularly risk a change in blood biochemistry, which could result in sodium and potassium changes eventually effecting cardiac conduction and the ECG?
Thiazide diuretics
