Hypertension

Question 1

What is Hypertension?

Answer 1

Hypertension (high blood pressure) is when the pressure in your blood vessels is too high (140/90 mmHg or higher).

Medical condition in which Constricted arterial blood vessel increase the resistance to blood flow, causing an increase in BP against the vessel walls.

Question 2

Epidemiology of Hypertension?

Answer 2

• very common, prevalence 48% of adult in SA
• 2nd leading risk factor for death in SA.
• likely to cause cerebral haemorrhage, renal disease, left ventricular hypotrophy in African patients.
• CAD major outcome related to hypertension in people from white and indian communities

Question 3

Hypertension defintions

Answer 3

Hypertension is higher 140/90mmHg
High normal qual>130-139/85-89mmHg*increased risk of developing hypertension.

hypertension emergency= life threating
hypertension urgency= symptomatic hypertension, NOT life threating.
White Coat hypertension= Elevated BP in a clinical setting and normal in other settings “scared of doctors.

Question 4

What are the grades of hypertension

Answer 4

1. 140-159/90-98mmHg
2. 160-179/100-109mmHg
3. equal >180/110mmHg

Question 5

Classification of hypertension?

Answer 5

primary HP= Elevated BP w/t unknown cause. *
secondary= Elevated BP w/t specific cause.

Question 6

What are the Signs and symptoms of hypertension?

Answer 6

• silent killler
• Asymptomatic
• fatigue
• dizziness
• blurred vision
• palpation
• angina
• difficulty breathing

Question 7

What complications are associated with hypertension?

Answer 7

• CVS disease
• athlerosclerosis
• coronary artery disease
• stroke
• angina
• kidney damage
• heart failure
• cerebrovascular disease.

Question 8

What are the clinical syndromes of hypertension?

Answer 8

• Asymptomatic
• Hypertension urgency
• hypertension emergency
• white coat hypertension
• Malignant hypertension
• Gestational hypertension

Question 9

What is Gestational Hypertension?

Answer 9

Development of hypertension in pregnant women after 20 weeks of gestation. > 140/90mmHg

Question 10

What are the risk factors associated with gestational hypertension?

Answer 10

• 1st pregancy
• prior kidney disease
• family history of gestational hypertension
• < 20 years or 40+

This can be managed either through early delivery, rest, lifestyle modif

Question 11

What is Malignancy Hypertension?

Answer 11

a term that has been used to describe patients with elevated blood pressure (BP) and multiple complications (End organ damage) with a poor prognosis.
Severely elevated BP equal>180/110mmHg *hypertensive crisis

• high risk of complications, evidence of direct damage to one or more organs.
• mostly CVS, CNS, and renal system.

Question 12

Dscribe the Pathology of Hypertension

Answer 12

Factors that can lead to HP;
1. Triggers
2. Genetics
3. Background

This then leads to the Natruresis and volume depletion that causes BP to rise vascular resistance. = development of hypertension.

Question 13

How does one assess hypertension?

Answer 13

Determine whether the HP is due to lifestyle, co-existing, or genetics
Or if there is a target organ.

Question 13

Describe the process of assessing Hypertension?

Answer 13

1. Patient History
   - Family Background
   - Pre-existing disease
   - Childhood
   - Symptoms
   - complications
   - Pregnancies
2. Examination
3. Management
   - lifestyle changes through healthier diet, exercise and a low sodium intake.

Question 14

How does one prevent Hypertension?

Answer 14

• screening in primary health care
• lifestyle modifications
• control risk factors
• monitor BP
• DASH diet