Hypertension Flashcards

1
Q

What is hypertension

A

High blood pressure

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2
Q

What is hypotension

A

Low blood pressure

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3
Q

If in a consultation a patient presents high blood pressure, what do you do next

A

Take measurements on both arms if the difference if more than 15 of the recommended.
Take another one then with the highest arm take a 3rd reading

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4
Q

If the clinical blood pressure is between 140/90 - 180/120 what should be carried out

A

Ambulatory ( close monitoring for 24hours) blood pressure monitoring should be carried

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5
Q

What BP is considered as hypertension

A
  • 140/90 or higher (150/90) for adults aged over 80
  • a day time ambulatory blood pressure of 135/85 or higher
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6
Q

What is the ranges of stage 1 hypertension

A

140/90 - 159/99 and subsequent ABPM of 135/85 - 149/94

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7
Q

What is stage 2 hypertension

A

160/100 - 180/120 with an ABPM of 150/95 and higher

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8
Q

What is stage 3 hypertension

A

When the BP is 180/120 and higher

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9
Q

What is accelerated hypertension

A

An accelerated hypertension in which the blood pressure reaches 180/120 and above and also the level this high is associated with progressive organ damage.

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10
Q

What is the name of the hypertension that has no identifiable cause but gradually gets worse over the years

A

Primary/ Essential hypertension

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11
Q

Is hypertension passed on

A

No, thus having someone with hypertension in your family doesn’t mean you’ll also have it

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12
Q

What is secondary hypertension

A

Hypertension that occurs as a result of other health conditions

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13
Q

What is amlodipine

A

Calcium channel blocker 2

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14
Q

How does amlodipine work

A

It acts on the myocardial muscles, myocardial conducting system and the vascular smooth muscle and it worlks by inhibiting Ca2+ influx

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15
Q

What is the bioavailability of amlodipine via the oral route

A

Roughly 60%

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16
Q

What is the half life of amlodipine

A

30-50 hours

17
Q

What is steady-state plasma concentrations

A

The concentration in which the drug concentration consistently stays., the equilibrium in which drug concentration consistency stays.

18
Q

What is angiotensin

A

A hormone that regulates your blood pressure by narrowing blood vessels

19
Q

What are Angiotensin converting enzymes

A

These are enzymes that converts inactive ang I to ang II and degrades active bradykin

20
Q

What are ace inhibitors

A

These are drugs that inhibit ACEnzymes that are used to lower high blood pressure by relaxing veins and arteries

21
Q

What is the mechanism of action for lisinopril

A

It inhibits the angiotensin converting enzyme in the reninangiotensin system.

22
Q

What is the oral bioavailability of lisinopril

23
Q

How long does it take for the peak plasma concentration to be reached

24
Q

What is the half life of lisinopril

25
Is lisinopril water soluble and why is that important
Yes and so is not metabolised and so is excreted unchanged
26
What are ARBs
Angiotensin receptive blockers. These are selective competitive Blockers of the AT1 (angiotensin II type 1) receptor
27
What are diuretics
A drug that increases urination by reducing fluid build up/storage
28
What are thiazides?
These are a types of diuretics that are used to treat high blood pressure and heart failure
29
How do the thiazide diuretics work?
They inhibit Na+ and cl- reabsorption by blocking the na+, c- symporter. However should be taken at lower doses to have a more prominent vasodilations effect than a diuretic effect
30
Three examples of ACE inhibitors
- Lisinopril - ramipril - enalapril
31
What different types of drugs can be administered to treat hypertension
- CCBs ( calcium channel blockers) - ACE inhibitors ( angiotensin converting enzyme inhibitors, stops the production of angiotensin) - A2RBs (angiotensin II receptor blocker) - Thiazide like diuretics
32
What is the first step in the treatment of hypertension under 55 and over 55
Under 55 - ACE inhibitors or A2RBs Over 55 and black - CCBs
33
What happens in step 2 treatment of hypertension
If step 1 is unsuccessful in treating hypertension: - Offer a CCB in combination with an ACE inhibitor/ A2RB, if CCB not suitable then offer a thiazide like diuretic - in black people an A2RB should be offered in preference to an ACE inhibitor to have alongside the CCB
34
What happens in step 3 hypertension
- ensure that all the dosages in step 2 are optimal before combing all three meds: A2RB, CCB and ACE inhibitor
35
What is resistant hypertension
When a patient is under stage 3 treatments however their BP is still above 140/90.
36
What happens in stage 4 hypertension treatment
- additional diuretics - higher dosage of diuretics. - using alpha or beta blockers