hypertension Flashcards
what is the WHO classification for hypertension
140/90 mmHg on at least two readings on separate occasions
vascular changes that occur with hypertension (2)
- Accelerates atherosclerosis
- Causes thickening of media of muscular arteries
how do kidneys affect hypertension
Can cause or result from renal disease
Kidney size often reduced and small vessels show intimal thickening and medial hypertrophy
characteristic features of hypertension
Markedly raised diastolic BP (usually over 120mmHg)
Progressive renal disease
8 risk factors for hypertension
Family history
Old age
Low birthweight
Male
Afro-Caribbean’s
Unhealthy diet
Lack of physical activity
Obesity
what is essential primary origin hypertension
occurs when you have abnormally high blood pressure that’s not the result of a medical condition
90% are this
secondary causes of hypertension (5)
- renal
- endocrine
- Coarctation of the aorta
- Pre-eclampsia occurring during third trimester of pregnancy
- drugs
which endocrine conditions can cause hypertension (3)
Conn’s syndrome, acromegaly, Cushing’s syndrome
which drugs can cause hypertension (3)
oestrogen-containing oral contraceptives
NSAIDs
vasopressin
is there signs and symptoms for hypertension
no most people are asymptomatic
except for in malignant hypertension
may have the occasional headache
what investigations for hypertension
blood pressure
tests to asses end organ damage
how to confirm diagnosis if blood pressure is more than 140/90
24-hour ambulatory BP monitor (ABPM)
Multiple home BP monitoring (if patient can’t tolerate ABPM)
when is treatment given
if ABPM 135/85
what tests can you do to assess end organ damage (5)
- Urinalysis to check kidneys (protein, albumin: creatine ratio and haematuria)
- ECG/Echo for LV hypertrophy
- Fundoscopy to assess hypertension retinopathy
- Bloods
Serum creatinine
eGFR
Glucose – assess diabetes risk - Clinical history – previous MI/strokes
what lifestyle changes can you do for hypertension
Smoking cessation
Low-fat diet + high consumption of fruit and vegetables
Reduce alcohol and salt intake
Increase exercise
Loss weight is obese
