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cardiovascular phase2a > Hypertension > Flashcards

Hypertension Flashcards

1
Q

Which factors interfere with BP measurements?

A

Stress, caffeine, exercise, eating, smoking (acutely increases BP), arm position, clothing, size of cuff, crossed legs, room temperature, talking

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2
Q

Why is it important to treat high BP?

A

Reduces headaches

Prevents problems in future - stroke, MI, CHD, HF, kidney failure

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3
Q

What causes 85% of cases of high blood pressure?

A

Essential - no clue

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4
Q

What are the known causes of high BP?

A 
Angiotensin
Diabetes
Oral contraceptives
Physical inactivity
Stress
Lower education
Small family size
Obesity
Race
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5
Q

What are the adrenal factors contributing to hypertension?

A

Conn’s syndrome - excess aldosterone
Phaeochromocytoma - excess catecholamines
Cushing’s - tumour producing excess cortisol

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6
Q

What is the name of an aldosterone antagonist used to treat bilateral hyperplasia?

A

Spironolactone

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7
Q

What is the clinical picture of phaeochromocytoma?

A

Hypertension
Sweating
Hyperglycaemia
Symptomatic episodes - pallor, palpitations, panic, chest pain

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8
Q

Which renal disease can cause hypertension?

A

Scarring
Polycystic renal disease
Renal artery stenosis
Fibro-muscular disease

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9
Q

Which lifestyle factors can cause an increase in BP?

A 
Increased weight
Increased salt intake
Alcohol intake
Cold environmental temperature
Drugs - NSAIDs, combined oral contraceptive, corticosteroids, ciclosporin, cold cures, SNRI anti-depressants
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10
Q

How do thiazides work to reduce BP?

A

Block reabsorption of sodium at distal convoluted tubule

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11
Q

What are the contraindications to using thiazides?

A

Pre-existing gout/hypercalcaemia

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12
Q

What are the adverse effects of spironolactone?

A

Hyperkalaemia when given with ACE-I

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13
Q

What are the adverse effects of thiazides?

A 
Gout
Lower potassium
Increased glucose
Increased cholesterol
Increased calcium
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14
Q

What are the adverse effects of beta-blockers?

A

Worsening asthma
Worsening HF
Heart block
Cold peripheries

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15
Q

What are the contraindications?

A

Unstable HF
Heart block
Asthma

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16
Q

Which other drugs interact with beta-blockers?

A

Verapamil

17
Q

What is the mechanism by which ACE-I work?

A

Block conversion of angiotensin I to angiotensin II in lung

18
Q

Which receptor do angiotensin receptor blockers act on?

A

Angiotensin II receptor

19
Q

In which disease are ARBs superior to beta-blockers for treatment?

A

LVH

20
Q

What are the adverse effects of ACE-I and ARBs?

A

Angio-oedema (ACE-I) - swelling of soft tissue
First dose hypotension - start with low doses at night
Renal failure

21
Q

What are the contraindications to using ACE-I and ARBs?

A

Renal artery stenosis
Concurrent NSAIDs/potassium sparers
Pregnancy

22
Q

What are the two subclasses of CCBs and the name of the drugs in each class?

A

Dihydropyridines - pure vasodilators - amlodipine

Rate limiting vasodilators - verapamil

23
Q

What are the adverse effects of using dihydropyridines?

A

Flushing
Headache
Palpitations
Peripheral oedema

24
Q

What are the adverse effects of using rate limiting vasodilators?

A

HF

Constipation

25
Q

What are the contraindications for using rate limiting vasodilators?

A

Heart block/failure

Concurrent beta-blocker therapy

26
Q

What is the standard BP target in hypertension treatment?

A
27
Q

What is the BP target for high risk hypertension patients?

A
28
Q

What is the BP target for the elderly with hypertension and why?

A

cardiovascular phase2a (14 decks)

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