Hypertension Flashcards
What is the general BP target?
Below 140-90 but systolic is over 100
What is the rationale for drug use in hypertension?
Reduce premature cardiovascular morbidity and mortality and microvascular disease affecting the brain, kidneys and retinas.
When should blood pressure treatment be commenced?
When secondary causes are treated and have tried non pharmacological strategies such as exercise
What are 3 non-pharmacological strategies for hypertension management?
physical activity, weight reduction, reduce alcohol, moderate sodium restriction, healthy eating plan, smoking cessation, more mono, poly and omega 3 fatty acids
What are 5 drug options for hypertension?
ACEIs, ANG2RAs/sartans, thiazide diuretics, CCBs and BBs
How does ACEIs help with hypertension?
reduce ANG2 levels and increase bradykinin levels leading to vasodilation, reduce aldosterone secretion
How do ANG2RAs help with hypertension?
they are competitive antagonist of ANG2, they don’t increase bradykinin levels
How do thiazide diuretics help with hypertension?
water and sodium loss, causes vasodilation
How do BBs help with hypertension?
competitively inhibit adrenaline and noradrenaline at beta receptors, reduce renin release, CO and peripheral resistance
What are three side effects of ACEIs or ARBs?
othostatic hypotension, hyperkalaemia, renal artery stenosis, drug interactions, cough
What are the first line drugs for hypertension?
ACEIs (or ARB), dihydropyridine CCB or thiazide diuretic if pt is 65 or older.
What 2 things should you monitor with an ACEI or ARB?
renal function, urea and electrolytes
What are 3 comorbidities associated with hypertensive chocie?
diabetes, dysipidemia, family hx and smoking as well as their overall CV risk
What are 3 factors associated with CVD risk
o Recent stroke
o 45-79 years
o Diabetes (35-79 years)
o 30-79 years First Nations
