Hypertension

Question 1

Hypertension?

Answer 1

• Or high blood pressure is when the pressure in your blood vessels unusually high.

Question 2

Hypertension classification?

Answer 2

Category SBP DBP
• Optimal: <120 <80
• Normal: <130 <85
• High-Normal: <130-139 < 85-89
• Grade 1: 140-159 90-99
• Grade 2: 160-179 100-109
• Grade 3: >oe to 180. >oe to 110

Question 3

Pathogenesis (causes)?

Answer 3

• Genetic tendency
• High salt intakes
• Excessive use of alcohol
• Insulin resistance
• Smoking, cigarettes

Question 4

Clinical findings (symptoms)?

Answer 4

• Headache
• High BP
• Tinnitus
• Tiredness
• Palpitation

Question 5

Investigations ?

Answer 5

• Hb
• HbA1c
• Urinalysis
• Renal function
• Serum potassium
• Plasma lipids
• Fasting glucose
• Fundus examination
• ECG, chest X-ray

Question 6

Risk factors?

Answer 6

• level of SBP and DBP (grade 1-3)
• Men > 55 yo, Female > 65yo
• Diabetes
• Smoking
• Family history of premature cardiovascular disease

Question 7

Complications?

Answer 7

• Hypertensive cardiovascular disease
• Hypertensive cerebrovascular disease
• Hypertensive nephropaty disease
• Hypertensive retinopathy disease
• Aortic dissection (tear of aorta)

Question 8

Management?

Answer 8

• Lifestyle modification, which include:
- Low salt intake 59g/day
- Stop smoking
- Reduce alcohol consumption
- Increase veggies and fruits intake
- Regular exercise

Question 9

Pharmacologic therapy ?

Answer 9

• A- ACE inhibitors (ramipril)
• B- Beta blockers ( bisoprolol)
• C- Calcium channel blockers ( amlodipine)
• D- thiazide-like Diuretic (inadopamide)
• ARB- Angiotesis II receptor blocker
  • 🚩: ARBs and ACE can’t be used together
  • ARBs are recommended instead of ACE in patients of black African