Hypertension Flashcards
Diagnosis of hypertension
If clinic BP is 140/90 mmHg or higher, offer ambulatory blood pressure monitoring (ABPM) to confirm the diagnosis of hypertension
How does APBM work?
At least 2 measurements per day
HBPM?
- 2 consecutive seated measurements, 1 minute apart
- do this for 4 days (preferably 7 days)
-measurements from first day are discarded, average of all remaining used
Stage 1 hypertension
Clinic BP is 140/90mmHg or higher and
ABPM or HBPM daytime average is 135/85mmHg or higher.
Stage 2 hypertension
Clinic BP 160/100mmHg or higher and
ABPM or HBPM daytime average is 150/95mmHg or higher.
Severe hypertension
Clinic BP is 180mmHg or higher or
Clinic diastolic BP is 110mmHg or higher.
If someone has hypertension, which other tests should you offer?
- Urine for protein
- Blood to measure glucose, electolytes, creatinine, estimated glomerular filtration rate and cholesterol
- Examine FUNDI for retinopathy
- Arrange a 12 lead ECG
Main driver of absolute risk for hypertension?
Age
What is your CV risk if you have established vascular disease? (e.g. ischaemic heart disease, cerebro-vascular disease, PVD, diabetes)
20%
Treatment for stage 1 hypertension
(consider specialist referral if under 40)
- Offer lifestyle interventions
- Offer patient education and interventions to support adherence to treatment
- OFFER ANNUAL review
How often should you review people with stage 1 hypertension?
At least annually
Treatment for stage 2 hypertension?
Offer anti-hypertensive drug treatment (and everything offered for stage 1 hypertension management)
Target clinic blood pressure?
140/90 in people under 80
150/90 in people over 80
Target ABPM/HBPM?
135/85 in people under 80
145/85 in people over 80
