Hypertension Flashcards
What are the thresholds for diagnosis of hypertension?
140/90 clinic BP
135/85 ambulatory BP
What is the main cause of hypertension?
Essential hypertension - unknown cause
What are the secondary causes of hypertension?
ROPED
R - renal failure
O - obesity
P - pre-eclampsia
E - endocrine
D - drugs - NSAIDs, alcohol, steroids, oestrogen
What is the most common cause of secondary hypertension?
Renal failure
What are the risks of high blood pressure?
Increased risk of:
- Stroke
- IHD
- Heart failure
- Left ventricular hypertrophy
- Hypertensive retinopathy
- Kidney failure
- Vascular dementia
What is stage 1 hypertension?
Clinic BP >140/90
Ambulatory BP > 135/85
What is stage 2 hypertension?
Clinic BP > 160/100
Ambulatory BP > 150/95
What is stage 3 hypertension?
Clinic BP > 180/20
What investigations should all those with a new diagnosis of hypertension have?
Urine albumin:creatinine ratio
Urine dipstick
HbA1c
Renal function
Lipids
Fundoscopy
ECG
Calculate Q risk
TFTs - check for secondary causes
What medications are used in the management of hypertension?
Under 55:
- 1st line - ACE inhibitor
- 2nd line - ARB
Over 55:
- 1st line - calcium channel blocker
Black or afro-carribean background:
- 1st line - CCB
Type 2 diabetes patients
- 1st line - ACE inhibitor
Alternative medications:
- Beta blockers + potassium sparing diuretics - 4th line
- Thiazide like diuretic - 3rd line
What is malignant hypertension?
Hypertension above 180/120 with papilloedema
What is the treatment of malignant hypertension?
Same day referral for IV antihypertensives:
- Sodium nitroprusside
- Labetolol
- GTN
- Nicardipine
What lifestyle changes can patients make to manage their hypertension?
Stop smoking
Reduce alcohol intake
Reduce caffeine intake
Reducing dietary salt
Diet and exercise
What should be monitored in patients on antihypertensives?
Serum electrolytes
Kidney function
Check blood pressure
Which thiazide like diuretic is most commonly used in hypertension?
Indapamide
