Hypertension

Question 1

What is the definition of hypertension?

Answer 1

A disorder in which the sustained arterial pressure is higher than expected for the age, sex and race of the individual

Question 2

What value do the WHO say defines hypertension?

Answer 2

> 140/90

Question 3

What is white coat hypertension?

Answer 3

Blood pressure is higher when taken in a medical setting than it is when taken at home

Question 4

What 4 conditions is hypertension a risk factor for?

Answer 4

Cerebral heamorrhage
Atheroma
Renal failure
Sudden cardiac death

Question 5

Describe the incidence of hypertension

Answer 5

Increases with age
High in the black population
Lower in the south pacific
Family tendency

Question 6

How is hypertension classified?

Answer 6

According to cause (aetiological) - primary and secondar hypertension
According to consequences

Question 7

List complications of atheroma

Answer 7

Stenosis
Thrombosis
Aneurysm
Dissection
Embolism
Ischaemia

Question 8

What is arterial stenosis?

Answer 8

Narrowing of the arterial lumen. Results in reduced elasticity, reduced flow in systole and tissue ischaemia

Question 9

What is cardiac fibrosis?

Answer 9

Loss of cardiac myocytes and replacement by fibrous tissue

Loss on contractility, reduced elasticity and filling

Question 10

What is an aneurysm?

Answer 10

Abnormal dilatation of an artery

Question 11

What is the blood pressure for stage 1 hypertension?

Answer 11

Clinic BP is 140/90 mmHg or higher
AND
ABPM or HBPM daytime average is 135/85 mmHg or higher

Question 12

What is the blood pressure for stage 2 hypertension?

Answer 12

Clinic BP is 160/100 mmHg or higher AND

ABPM or HBPM daytime average is 150/95 mmHg or higher

Question 13

What is the blood pressure for severe hypertension?

Answer 13

Clinic BP is 180 mmHG or higher OR clinic diastolic is 110 mmHg or higher

Question 14

What is what coat hypertension?

Answer 14

When a patient has an abnormally high blood pressure when it is taken in a medical setting

Question 15

What class of drugs would you give a hypertensive patient if they were under 55 years old?

Answer 15

Angiotensin converting enzyme inhibitor

Or if they get a dry cough with this, angiotensin II receptor blocker instead

Question 16

What class of drugs do you give to treat hypertension in those older than 55?

Answer 16

Calcium channel blockers

Question 17

What drugs do you prescribe in all hypertensive patients of African or Caribbean origin of any age?

Answer 17

Calcium-channel blocker (CCB)

Question 18

What do you prescribe if a calcium-channel blocker is not suitable?

Answer 18

A diuretic

Question 19

What is step 2 treatment for hypertension?

Answer 19

Combination of ACE inhibitor and CCB

Question 20

What is the target blood pressure for people under 80?

Answer 20

140/90 mmHg

Question 21

What is target blood pressure for people aged 80 and over?

Answer 21

150/90 mmHg

Question 22

What are the generic drugs used in hypertension?

Answer 22

ACEI/ARB
CCB
Diuretics 
B blocker
A blocker
Spironolactone