Hypertension Flashcards

1
Q

Define Hypertension

A

> 140mmHg/90mmHg on more than two occasions. or >135mmHg/85mmHg with 24hr ECG.

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2
Q

Hypertension’s role in Cardiovascular disease

A

Hypertension leads to sheering forces in the vessels. leads to development of Atherosclerotic disease.
Causes hypertrophy of Left ventricle and can lead to heart failure.

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3
Q

Causes of Hypertension

A

Primary (Essential) hypertension has no cause

Secondary Causes: Conn’s syndrome, Cushings, Phaeochromocytoma, Acromegaly, hyperparathyroidism.
Renal vascular disease -

Malignant hypertension is a rapid increase in BP that causes vascular damage.

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4
Q

Diagnosis of Hypertension

A

If >140mmHg/90mmHg then further investigations needed. Second visit and measurement.
24hour/Ambulatory BP measurement used. If >135mmHg/85mmHg then Stage 1, If >150/95mmHg Stage 2.

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5
Q

Presentation of hypertension

A

Asymptomatic.

Malignant hypertension may present with headache and visual disturbances.
Retinopathy - flame haemorrhages, cotton wool spots, copper wiring.
LVH.
Signs of Renal disease.

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6
Q

Investigation of HTN

A

BP recognises incidental findings. then 24hour/Ambulatory BP.
Opthalmoscope to look at retina’s can indicate any complications.
ECG for signs of LVH, Echo for LVH
Bloods: BM, Cholesterol, U+Es for kidney function, low K+ (Conn’s), Renin:aldosterone levels, Ca++ + PTH, metanephrines (phaeo) cortisol levels.
Urine dip

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7
Q

Management of Hypertension.

A

Reduce risks of CVD - smoking, glucose, cholesterol, salt restriction.
Treat underlying causes - Endocrine/Renal disease.
Aim<130/80.

Then proceed to monotherapy, then combination.

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8
Q

Pharmacological treatment.

A

If 55yr/Afro - Ca blocker/Thiazide diuretic.

Then add in.
If dual therapy not improving add beta blocker/spironolactone. Do not give beta blockers with Ca blocker.

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