hypertension Flashcards
what is the increase risk of mortality with each 2mmhg bp
7% heart disease
10% stroke
what proportion of the uk population have hypertension
25%
what proportion of people over 60 have hypertension
50%
what is stage one hypertension
clinic = 140/90 ABPM = 135/85
what is stage 2 hypertension
160/100
ABPM= 150/95
what is stage 3/ severe hypertension
clinic =180 syt or 110 diastolic
what people are not included in the definition of primary hypertension
diabetics 2ary hypertension acute hypertension pregnant people children and young people
who should be offered ABPM
140/90
how is ABPM performed
at least two measurements per hour during the day, at least 14 measurements
How is HBPM performed
two consecutive seated measurements 1 min apart
record twice a day for 4 days
measurement on the first day is discarded and then take the average
who should be offered antihypertensive drug treatment
stage 1 hypertension below 80
stage 2 hypertension at any age
how should people under 40 with stage 1 hypertension be managed
investigate 2ary causes of hypertension
assess for target organ damage
what target blood pressure should be aimed for
140/90 in people aged below 80, else 150/90
ABPM should be 5 lower
in what cases should antihypertensive drugs be offered
stage 2 hypertension
or organ damage present
or 10 year cardiovascular risk >20%
what drugs should be offered to those under 55 who are not African/ caribbean
ACE or ARB
what should be offered to those over 55 or of African/ Caribbean descent
Calcium blocker
what should be offered as a second antihypertensive
A and C
what should be offered as a third antihypertensive
A, C, AND thiazide diuretic
what should be offered as a 4th antihypertensive
further diuretic, alpha or beta blocker
seek expert advice
what lifestyle interventions should be offered
diet and exercise sodium and caffeine alcohol smoking patient organisations pros and cons of medications ANNUAL CARE REVIEW
what part of the brain measures osmolality
hypothalamus
what parts of the vascular system detect low stretch
atria and pulmonary vessels
what parts of the vascular system detect high stretch
aortic arch, carotid sinus and juxtaglomerular apparatus
how does the medulla oblongata regulate BP
varies ADH from pituitary
plus sympathetic activity
