Hypertension

Question 1

What pressure does blood pressure measure? Arterial or venous?

Answer 1

Arterial

Question 2

What is normal blood pressure?

Answer 2

120/80

Question 3

What is the unit for measuring blood pressure?

Answer 3

mmHg

Question 4

What is the difference between systolic and diastolic, in terms of BP?

Answer 4

Systolic = heart contraction

Diastolic = heart relaxation

Question 5

List some things that could interfere with blood pressure measurement?

Answer 5

Stress
Talking
Caffeine
Exercise
Eating
Smoking
Position of arm
Temperature
Environment

Question 6

What does smoking do to blood pressure?

Answer 6

Raises it

Question 7

Why are 24 hour blood pressure monitors used?

Answer 7

To get more reliable information on someone’s blood pressure

No white coat effect
More readings

Question 8

What is the link between age and blood pressure?

Answer 8

Usually increases with age

Until about age 70 when it starts declining due to frailty

Question 9

What problems does high BP cause?

Answer 9

Stroke
Myocardial infarction
Coronary heart disease
Heart failure
Renal failure

Question 10

Is it males or females that get hypertension more?

Answer 10

Males more than females

Question 11

What is the most common causes of hypertension?

Answer 11

No explanation!

Question 12

What are the causes of hypertension?

Answer 12

Idiopathic

Overproduction of aldosterone
Adrenal causes
Renal disease
Drugs
Rare hormone secreting tumours

Question 13

What percentage of cases of hypertension are down to genetics?

Answer 13

20-35%

Question 14

Name 3 adrenal disorders that cause hypertension?

Answer 14

1. Primary aldosteronism: Conn’s syndrome
2. Phaeochromocytoma
3. Cushing’s Syndrome

Question 15

What is primary aldosteronism (Conn’s syndrome)?

Answer 15

Excess aldosterone production by the adrenal glands

Caused by adrenal adenoma

Question 16

What are the symptoms of primary aldosteronism (Conn’s syndrome)?

Answer 16

High blood pressure
Headaches
Poor vision
Muscle cramps + spasms

Complications: CVS problems, renal problems

Question 17

What is Phaeochromocytoma?

Answer 17

Tumour of the medulla of the adrenal glands

Leads to excess production of catecholamines, adrenaline + (mainly) noradrenaline

They get symptomatic episodes

Question 18

What are the symptoms of Phaeochromocytoma?

Answer 18

Hypertension
Sweating
Hyperglycaemia

Symptomatic episodes:

• Pallor
• Palpitations
• Panic
• Pain in chest

Question 19

What are the features of a symptomatic episode of Phaeochromocytoma?

Answer 19

The 4 Ps

Pallor
Palpitations
Panic
Pain in chest

Question 20

What is Cushing’s syndrome?

Answer 20

Elevated cortisol levels in the blood

Cushing’s disease = a tumour that produces excess cortisol, can be benign or malignant

Question 21

What are the symptoms of Cushing’s syndrome?

Answer 21

Hypertension

Abdominal obesity but thin arms & legs

Stretch marks

Fat lump between shoulders

Weak bones

Acne

Moon face (rounded face)

Question 22

What renal diseases can cause hypertension?

Answer 22

Fibrotic / scarred kidneys

Polycystic kidneys

Renal artery stenosis

Question 23

How does renal artery stenosis lead to hypertension?

Answer 23

The kidney receives less blood supply due to the stenosis

Low kidney perfusion triggers release of renin

Renin-angiotensin-aldosterone pathway raises blood pressure

Question 24

What causes renal artery stenosis?

Answer 24

Atheromas

Fibromuscular disease

Question 25

What lifestyle factors influence blood pressure?

Answer 25

Weight
Salt
Alcohol
Smoking
Drugs