Hypertension Flashcards
What is the likely cause of primary hypertension?
Increased reactivity of resistance vessels and resultant increase in peripheral resistance
Or a sodium homeostatic effect
What are other factors of primary hypertension?
age genetics environment weight alcohol intake race
What are the causes of secondary hypertension?
renal disease drugs pregnancy endocrine vascular
What are the stages of hypertension?
stage 1 - ABPM daytime average of 135/85
stage 2 - ABPM daytime average of 160/95
severe - clinic systolic is 180
What would you treat a patient 55 years old with in step 1 of treatment?
Calcium channel blocker
What would you treat a patient 30 year old patient with in step 1 of treatment?
ACE inhibitor or ARB
Unless they are afro-carribean or women of child barring age
What would you add in step 2 of treatment?
A thiazide type diuretic such as clortalidone to the existing medication
What would you do for resistant hypertension?
Further diuretic therapy
What are the adverse drug reactions of ACEI?
cough and first dose hypertension
What are the contraindications of ACEI?
renal artery stenosis
renal failure
hyperkalaemia
What are the drug-drug interactions of ACEI?
NSAIDS precipitate acute renal failure
Potassium supplements
Potassium sparking diuretics
What is an example of ACEI?
Ramipril, Perindopril
What is an example of an ARB?
Losartan, valsartan
What is the advantage of ARB over ACEI?
No cough
What is an example of vasodilator CCBs?
amlodipine or felodipine
