Hypertension Flashcards

1
Q

hypertension blood pressure
how common
risk factor for…

A

> =140/90mmHg
50% of >60 years
stroke, myocardial infarction, heart failure
‘silent killer’

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2
Q

causes of primary hypertension(90-95%)

A

family history
obesity
excess salt in diet
excess alcohol intake

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3
Q

causes of secondary hypertension(5-10%)

A

reno(vascualr)
endocrine
coarctation of aorta
pregnancy induced
exogenous hormones

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4
Q

possible consequences of not diagnosing and treating hypertension

A

can lead to heart attack, stoke or end-stage renal failure

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5
Q

how to measure blood pressure

A

sphygmomanometer- rubber cuff on arm connected to column of mercury attached to graduating scale. determines BP by increasing and releasing pressure in cuff

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6
Q

types of manual BP devices

A

aneuroid sphygmomanometer
mercury sphygmomanometer

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7
Q

types of automated BP devices

A

digital monitor- general use
ambulatory monitor- portable
‘waiting room’ BP monitor- GP surgery

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8
Q

steps for taking BP

A

choose correct cuff size
patients sit and rest for 5 mins
place their arm at heart level
make sure they dont talk or move while taking BP

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9
Q

How to use manual monitors

A

palpate brachial artery
inflate cuff until palpations disappears
deflate cuff
inflate to 30 more than pressure when palpation disappeared
place stethoscope on brachial artery and deflate slowly until hear tapping sound
measure systolic and diastolic

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10
Q

Diagnosis and investigation of hypertension

A

> 140/90mmHg clinical BP
135/85 ABPM BP
if this is case record again, if vastly different take a third and only record lower of last 2 readings
also offer ambulatory blood pressure monitoring
if cant handle ABPM offer home blood pressure monitoring

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11
Q

severe hypertension

A

BP(systolic)>=180 or BP(diastolic)>=120
start antihypertensiondrug treatment ASAP
as if left untrated can lead to end organ damage

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12
Q

factors that suggest hypertension

A

clinical BP 140/90mmHg or higher with HBPM 135/85 or higher
stage 1- clinical BP>=140/90 and BP<=159/99
stage 2 BP>=160/100

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13
Q

investigations

A

-target organ damage: urinanalysis, ECG, fundoscopy
-secondary causes: MR renal angiogram, plasma renin, aldesterone levels, endocardiogram

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14
Q

treatment

A

lifestyle intervention- weight loss (diet and exercise)
target BMI 20-25
reduce alcohol intake
reduce caffine intake
reduce salt intake
treat secondary causes- adrenal tumor surgery
antihpertension drug therapy- depends on age, ethnicity, reactivity
Ace inhibitors
Beta blockers
Calcium channel blockers
Diuretics

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15
Q

what drug to choose

A

depends on age, ethnicity, previous adverse reaction
A(B)CD method to decide
ACE inhibitors/ angiotensin receptor blocker
beta blockers
calcium channel blocker
diuretics

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16
Q

steps to decide drug

A

if younger than 55 give (A) unless patient is black
then decide to give with C,D or both
if patient is older than 55 or black give C,D or both