Hypertension Flashcards
What is the definition of hypertension?
A disorder in which the sustained arterial pressure is higher than expected for the age, sex and race of the individual
What value do the WHO say defines hypertension?
> 140/90
What is white coat hypertension?
Blood pressure is higher when taken in a medical setting than it is when taken at home
What 4 conditions is hypertension a risk factor for?
Cerebral heamorrhage
Atheroma
Renal failure
Sudden cardiac death
Describe the incidence of hypertension
Increases with age
High in the black population
Lower in the south pacific
Family tendency
How is hypertension classified?
According to cause (aetiological) - primary and secondar hypertension
According to consequences
List complications of atheroma
Stenosis Thrombosis Aneurysm Dissection Embolism Ischaemia
What is arterial stenosis?
Narrowing of the arterial lumen. Results in reduced elasticity, reduced flow in systole and tissue ischaemia
What is cardiac fibrosis?
Loss of cardiac myocytes and replacement by fibrous tissue
Loss on contractility, reduced elasticity and filling
What is an aneurysm?
Abnormal dilatation of an artery
What is the blood pressure for stage 1 hypertension?
Clinic BP is 140/90 mmHg or higher
AND
ABPM or HBPM daytime average is 135/85 mmHg or higher
What is the blood pressure for stage 2 hypertension?
Clinic BP is 160/100 mmHg or higher AND
ABPM or HBPM daytime average is 150/95 mmHg or higher
What is the blood pressure for severe hypertension?
Clinic BP is 180 mmHG or higher OR clinic diastolic is 110 mmHg or higher
What is what coat hypertension?
When a patient has an abnormally high blood pressure when it is taken in a medical setting
What class of drugs would you give a hypertensive patient if they were under 55 years old?
Angiotensin converting enzyme inhibitor
Or if they get a dry cough with this, angiotensin II receptor blocker instead
What class of drugs do you give to treat hypertension in those older than 55?
Calcium channel blockers
What drugs do you prescribe in all hypertensive patients of African or Caribbean origin of any age?
Calcium-channel blocker (CCB)
What do you prescribe if a calcium-channel blocker is not suitable?
A diuretic
What is step 2 treatment for hypertension?
Combination of ACE inhibitor and CCB
What is the target blood pressure for people under 80?
140/90 mmHg
What is target blood pressure for people aged 80 and over?
150/90 mmHg
What are the generic drugs used in hypertension?
ACEI/ARB CCB Diuretics B blocker A blocker Spironolactone
