Hypertension

Question 1

What is hypertension?

Answer 1

Raised blood pressure

Question 2

What would be an expected reading of someone with hypertension?

Answer 2

Equal to or above 140/90

Question 3

How should blood pressure be measured?

Answer 3

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.

Question 4

What is ambulatory measuring?

Answer 4

Measuring blood pressure at regular intervals over a 24 hour period while patients undergo normal daily activities, including sleep.

Question 5

Which ethnic groups are at higher risk of developing hypertension?

Answer 5

African, Caribbean and south Asian ethnicities

Question 6

Why might African, Caribbean and south Asian ethnicities be at higher risk to hypertension?

Answer 6

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

Question 7

The treatment of hypertension has what effect on patients risk of coronary heart disease?

Answer 7

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.

Question 8

What is another name for coronary heart disease?

Answer 8

Atherosclerosis

Question 9

The treatment of hypertension has what effect on the outcome of heart failure?

Answer 9

Significant improvement in risk of heart failure, as reduces workload of heart, making muscle more able to cope

Question 10

What are the two common disease outcomes of hypertension?

Answer 10

• accelerated atherosclerosis
• renal failure

Question 11

What can be the consequence of accelerated atherosclerosis?

Answer 11

• myocardial infarction
• stroke
• peripheral vascular disease

Question 12

What is “essential” hypertension?

Answer 12

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.

Question 13

What is renal artery stenosis?

Answer 13

The narrowing of one or more arteries that carry blood to your kidneys

Question 14

What are the three hormones that endocrine tumours release which can be rare triggers for hypertension?

Answer 14

1. Adrenaline
2. Aldosterone
3. Cortisol

Question 15

What is the role of adrenaline, related to hypertension?

Answer 15

Acts as a vasoconstrictor

Question 16

What is the role of aldosterone and cortisol, relating to hypertension?

Answer 16

They increase circulating blood volume

Question 17

What neuroendocrine, adrenergic tumour may release adrenaline, in turn causing high blood pressure?

Answer 17

Phaeochromocytoma

Question 18

What syndrome is characterised by excess aldosterone production?

Answer 18

Conn’s syndrome

Question 19

What syndrome is a result of excess cortisol in the body over a long period of time?

Answer 19

Cushing’s syndrome

Question 20

What symptom is more common in malignant hypertension- where blood pressure is rapidly accelerating?

Answer 20

Headache

Question 21

What is a transient ischaemic attack?

Answer 21

Also known as a “mini stroke”, it is a serious condition where the blood supply to the brain is temporarily disrupted

Question 22

Where is the adrenal gland situated?

Answer 22

Just above the renal gland, within the region of the kidney.

Question 23

True or false?
Phaeochromocytoma is a renal disease.

Answer 23

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.

Question 24

Why is swelling a symptom of Cushing’s syndrome?

Answer 24

This syndrome results in salt/water retention, which leads to excess fluid within the circulation

Question 25

What is hypovolemia?

Answer 25

A condition where your body loses fluid, like blood or water

Question 26

What are the 4 investigations for hypertension?

Answer 26

1. Urinalysis
2. Serum biochemistry
3. Serum lipids
4. ECG

Question 27

What blood pressure is aimed for as a result of hypertension treatment?

Answer 27

BP < 120/90 mmHg

Question 28

What are the four most common drug types used to treat hypertension?

Answer 28

1. Thiazide diuretic
2. Beta blocker
3. Calcium channel antagonist
4. ACE inhibitor

Question 29

What is an example of a thiazide diuretic?

Answer 29

Dendroflumethiozide

Question 30

what is an example of a beta blocker?

Answer 30

Atenalol

Question 31

What is the side effect commonly associated with thiazide diuretic’s?

Answer 31

Gout (sudden swelling and severe pain in joints)

Question 32

What is the side effect commonly associated with beta blockers?

Answer 32

COPD & asthma

Question 33

What is the side effect commonly associated with calcium channel antagonist?

Answer 33

Gingival hyperplasia

Question 34

What is the side effect commonly associated with ACE inhibitors?

Answer 34

Peripheral vascular disease

Question 35

How often would you monitor someone with stable control of hypertension?

Answer 35

Annually

Question 36

How often would you monitor someone with unstable control of hypertension?

Answer 36

Every 2-3 months

Question 37

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?

Answer 37

Thiazide diuretics