Hypertension Flashcards

1
Q

Describe some complications of HTN

A
Brain- stroke, haemorrhage
Heart- LVH, CHD, CHF, MI
Kidney- renal failure, proteinuria 
Eye- retinopathy
Peripheral vascular Disease
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2
Q

Define Stage 1 HTN

A

Clinical BP= 140/90

ABPM- 135/85

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3
Q

Define Stage 2

A
Clinical= 160/100
ABPM= 150/95
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4
Q

Define Severe HTN

A

Either systolic over 180 or diastolic over 110

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5
Q

What percentage of HTN is primary (idiopathic)?

A

90%

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6
Q

Risk Factors?

A
Male 
Smoker
Age 55+ 
Post menopausal Women
Obesity
Previous MI/ Stroke
Diabetes
Hyperlipidaemia
General Low fitness
LV hypertrophy
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7
Q

How does birth weight influence HTN?

A

Low birth weight increases risk

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8
Q

What is the influence of genes?

A

May be more common in families- predisposed risk

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9
Q

List the causes of Secondary HTN

A
Renal Disease- sodium and water retention
Drug Induced- NSAIDs, OTC, Steroids
Pregnancy- pre-eclampsia
Endocrine- Conn's, Cushings
Vascular- coarctation of aorta
Sleep Apnoea
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10
Q

Name two ways of monitoring Blood Pressure

A

ABPM- ambulatory BP monitoring

HBPM- Home BP monitoring

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11
Q

How would you assess end organ damage?

A

ECG & ECHO- heart failure, LVH
Renal Ultrasound- Kidney failure, eGFR
Blood tests- proteinuria, LFT

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12
Q

What treatable causes would you screen for?

A
Renal Artery Stenosis
Fibromuscular Dysplasia
Cushings
Conn's Syndrome
Sleep Apnoea
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13
Q

Why treat HTN?

A

Reduce risk of Stroke by 40-50%

Reduce incidence of MI- 15-30%

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14
Q

How to treat?

A

Stepped Approach

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15
Q

Which drugs?

A

YOUNG U55= ACE Inhibitor/ ARB
Over 55= CCB
Afro Carribean= CCB
Women of child bearing age= CCB

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16
Q

Why use ARB not ACEI?

A

ACE Inhibitors cause a persistent annoying cough. ARBs are less likely to cause this.
Losartan, Valsartan

17
Q

Other drugs?

A

Thiazide Type Diuretic

  • Indapamide
  • Clortalidone.
18
Q

Resistant HTN?

A

Spironolactone 25m o.d. if Potassium is below 4.5mmol/l

19
Q

What does ACE stand for and name two types

A

Angiotensin Converting Enzyme
Ramapril
Perindopril

20
Q

When can you not use ACE Inhibitors?

A

Renal Failure, Renal Artery Stenosis, Hyperkalaemia

21
Q

CCB?

Name the two different actions and give examples

A

Calcium Channel Blocker
Vasodilator- Amlodipine
Rate Limiting- Diltiazem, Verapamil