Hypertension Flashcards
Definition of hypertension
the level of BP where treatment does more good than harm
when would you offer a ambulatory BP monitor?
if in clinic the BP is over 140/90
Risk factors for hypertension?
heavy alcohol consumption
smoking
obesity (reduces mmHg per kg)
diet - eg salt, fats etc
what drug action would you give a 45 year old white man with confirmed hypertension?
ACE inhibitor, then combine that with a calcium channel blocker if ineffective, finally add add a diuretic along with the other two medications
what drug action young you give a 60 year old white man with hypertension?
calcium channel blocker you be first line, then combine with an ace-inhibitor then if not working add a diuretic along with the other two treatments
first like for a black patient with confirmed hypertension?
calcium channel blocker
how do organic nitrates cause smooth muscle relaxation?
they are metabolised to NO
side effects of ACE inhibitors? why does this occur?
dry cough - bradykinin is no longer inactivated by the ACE enzyme, and it acts as a stimulant to sensory nerve fibre, which in turn stimulates the cough reflex
what would you do if a patient had a BP of 180/100?
consider giving hypertensive treatment and give ABPM to rule out any chance of white coat hypertension
when would you used beta blockers as first line?
if the patient what pregnant and an ACEI could not be given for the sake of the babies health
second line therapy in hypertension of all ages/ethnicity?
ACEI + CCB, or CCB and thiazide diuretic
third line?
combination of ACEI, CCB and thiazide diuretic
why are ACEI not first line in black/elderly patients?
because they have a less sensitive RAAS system - the system which ACEI act upon
