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Rothertrio 2a Cardiology > Hypertension > Flashcards

Hypertension Flashcards

1
Q

Define hypertension

A

High blood pressure

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2
Q

How can blood pressure be calculated?

A

Cardiac Output x Total Peripheral Resistance
- These factors can lead to increased BP

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3
Q

What are the 3 types of hypertension?

A
  • Primary
  • Secondary
  • Malignant
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4
Q

What is primary hypertension?

A

90% of the time, hypertension occurs naturally (idiopathic)

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5
Q

What is secondary hypertension?

A

the rest of the time, it occurs due to underlying conditions such as renal diseases, endocrine dysfunctions, drugs or pregnancy

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6
Q

What is malignant hypertension?

A
  • This is a severe increase in blood pressure and requires emergency assessment and treatment
  • Blood pressure is at or over 180/120mmHg
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7
Q

What are the stages of hypertension?

A

1, 2, 3

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8
Q

What are BP measurements for stage 1 hypertension?

A

140/90mmHg (C) 135/85mmHg (A)
C – Clinic A - Ambulatory

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9
Q

What are BP measurements for stage 2 hypertension?

A

160/100mmHg (C) 150/95mmHg (A)

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10
Q

What are the BP measurements for stage 3 hypertension?

A

180/120mmHg

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11
Q

What are modifiable risk factors for hypertension?

A

Smoking
Obesity
Alcohol
Sedentary Lifestyle
Poor Diet/High Sodium intake
Stress

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12
Q

What are non-modifiable risk factors for hypertension?

A

Older Age
Family History
African Heritage

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13
Q

What lifestyle advice would you tell someone with hypertension?

A

Advice on diet, exercise and weight loss
Stop smoking
Stop drinking alcohol
Salt Restriction

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14
Q

What are symptoms of hypertension?

A
  • Mostly asymptomatic and found when screening
  • May have pulsatile headache which is classically occipital and worse in the morning
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15
Q

What are signs of hypertension?

A

May present with signs of the underlying cause of secondary hypertension (e.g. phaeochromocytoma, hyperthyroidism or Cushing’s)

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16
Q

What are signs of malignant hypertension?

A

Hypertensive Retinopathy
Visual Disturbances
Cardiac Symptoms
Oliguria
Polyuria
End Organ Damage

17
Q

What are the complications of hypertension?

A
  • Heart Failure
  • Increased IHD Risk
  • CKD/Renal Failure
  • Peripheral Arterial Disease
  • Dementia
  • Increased Risk of Cerebrovascular Incidence
18
Q

How often do NICE recommend measuring BP for screening?

A

Every 5 years

19
Q

In whom are BP measurements done more frequently?

A

fast-tracked and done more frequently in borderline cases and in patients with diabetes

20
Q

What is used to diagnose BP?

A

Clinic BP measurement then ambulatory BP measurement to confirm

21
Q

Between what range of clinic BP reading is an ambulatory blood pressure offered to confirm diagnosis?

A

between 140/90mmHg and 180/120mmHg

22
Q

How does ambulatory blood pressure measure BP?

A

This 24-hour blood pressure measurement takes at least 2 measurements per hour

23
Q

What is the ambulatory BP measurement for stage 1 hypertension?

A

If it is over 135/85mmHg

24
Q

What is the ambulatory BP measurement for stage 2 hypertension?

A

over 160/95mmH

25
Q

What is ambulatory BP done to combat?

A

To combat white coat syndrome and account for people who get nervous in a clinic setting

26
Q

What investigations can be done to assess end organ damage in severe hypertension?

A
  • Fundoscopy (for retinopathy)
  • ECG (for Left Ventricular Hypertrophy)
  • Urinalysis (Renal dysfunction)
  • Bloods
27
Q

What is 1st line treatment for hypertension WITH T2DM?

A

ACEi or ARB (Angiotensin receptor blockers)

28
Q

What is 1st line treatment for hypertension WITHOUT T2DM and under 55 and not black african/ african caribbean?

A

ACEi or ARB

29
Q

What is 1st line treatment for hypertension WITHOUT T2DM and over 55?

A

CCB (calcium channel blockers)

30
Q

What is 1st line treatment for hypertension without T2DM and black african/ african caribbean (any age)?

31
Q

What is 2nd line treatment for hypertension WITH T2DM?

A

CCB
or
Thiazide-like diuretic

32
Q

What is 2nd line treatment for hypertension WITHOUT T2DM and under 55 and not black african/ african caribbean?

A

CCB
or
thiazide-like diuretic

33
Q

What is 2nd line treatment for hypertension WITHOUT T2DM and over 55?

A

ACEi/ ARB
or
thiazide-like diuretic

34
Q

What is 2nd line treatment for hypertension WITHOUT T2DM and black african/ african caribbean (any age)?

A

ACEi/ ARB
or
thiazide-like diuretic

35
Q

What is 3rd line treatment for hypertension?

A

ACEi/ ARB + CCB + thiazide-like diuretic

36
Q

What is 4th line treatment for hypertension?

A

Consider adding:
- low dose spironolactone if blood potassium ≤4.5 mmol/l
- alpha blocker/ beta blocker if blood potassium >4.5 mmol/l
Seek advice if BP uncontrolled on 4 drugs

Rothertrio 2a Cardiology (24 decks)

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