Hypertension Flashcards
How is hypertension defined?
Hypertension is persistently elevated blood pressure, typically ≥140/90 mmHg.
What is the difference between systolic and diastolic hypertension?
Systolic hypertension: High systolic BP (≥140 mmHg) with normal diastolic BP.
Diastolic hypertension: High diastolic BP (≥90 mmHg).
What are the two main types of hypertension?
Primary (essential) hypertension (90-95% cases) → No identifiable cause, linked to genetics, lifestyle, and aging.
Secondary hypertension (5-10% cases) → Due to an underlying condition (e.g., kidney disease, endocrine disorders).
What are common risk factors for primary hypertension?
Age, obesity, high salt intake, smoking, alcohol, sedentary lifestyle, stress, family history.
What conditions can cause secondary hypertension?
Chronic kidney disease, hyperaldosteronism, pheochromocytoma, coarctation of the aorta, obstructive sleep apnea.
What are the complications of untreated hypertension?
Cardiovascular disease (e.g., heart failure, myocardial infarction).
Stroke (ischemic or hemorrhagic).
Chronic kidney disease (due to renal damage).
Aneurysm formation.
Retinopathy (leading to vision loss).
Is hypertension treatment effective in both young and elderly patients?
Yes, studies like SHEP (Systolic Hypertension in the Elderly Program) and EWPHE (European Working Party on High Blood Pressure in the Elderly) show that treatment reduces stroke and heart failure risk in elderly patients.
What is the benefit of early treatment in young adults?
Prevents long-term complications like left ventricular hypertrophy and organ damage.
Why are hypertension treatment guidelines important?
Provide evidence-based recommendations for effective treatment.
Help standardize care and improve patient outcomes.
Minimize side effects by guiding drug selection.
Which studies support hypertension treatment guidelines?
VA studies (Veterans Administration Hypertension Study) → Showed BP control reduces complications.
MRC studies (Medical Research Council Trials) → Demonstrated benefits of antihypertensive drugs.
What is the stepped approach to treating hypertension?
Step 1: Lifestyle modifications (diet, exercise, weight loss, smoking cessation).
Step 2: Start with a single antihypertensive drug.
Step 3: Add a second drug if BP remains high.
Step 4: Combine three or more drugs if needed for better control
What is the preferred first-line treatment for younger and older patients?
Under 55 years: ACE inhibitors or ARBs (e.g., ramipril, losartan).
Over 55 years or Black patients: Calcium channel blockers (e.g., amlodipine) or thiazide diuretics.
What are the strengths of antihypertensive therapy?
Reduces risk of stroke, heart failure, and kidney disease.
Improves life expectancy.
Well-established evidence base from clinical trials.
What are the weaknesses of antihypertensive therapy?
Side effects (e.g., dizziness, fatigue, electrolyte imbalances).
Poor adherence due to long-term treatment.
Drug interactions.
What are the safe antihypertensive drugs for pregnancy?
Methyldopa (first-line).
Labetalol (beta-blocker).
Nifedipine (calcium channel blocker).
Which drugs are contraindicated in pregnancy?
ACE inhibitors & ARBs → Can cause fetal renal damage.
Thiazide diuretics → Risk of fetal hypoperfusion.
