Hypertension Flashcards
Blood pressure=
Cardiac Output* Peripheral Vascular Resistance
Parameters of grade 1 hypertension
140-159/90-99
Parameters of grade 2 hypertension
160-179/100-109
Parameters of grade 3 hypertension
> 180/>110
Parameters of prehypertension
130-139/85-89
Parameters of isolated systolic hypertension
systolic >140
diastolic <90
Tretatment for isolated systolic hypertension
Lifestyle interventions- less salt, weight loos, physical activity
Drugs only used if lifestyle changes are unsuccesful
Parameters of hypotension
90/60 and less
Parameters of postural hypotension
Systoli decrease >20mmHg when standing
Diastolic decrease >10mmhG if associated with fainting
How does being hypertensive change ones risk of stroke?
Sixfold increase in stroke
How does being hypertensive change ones risk of cardiac death
Threefold increase in cardiac death
How does being hypertensive change ones risk of developing peripheral arterial disease
Doubles
Hypertension leads to which kind of ventricular hypertrophy?
Concentric
What signs of damage in the retina can be blamed on hypertension?
Arteriolar narrowing and abnormalities at point where arterioles and venules cross
What is primary hypertension? % of cases of hypertension are primary?
Idiopathic- no underlying cause
90-95% of cases
What is secondary hypertension
Clear underlying cause
5% of cases
Name some causes of secondary hypertension
Renal disease Endocrine disease Coarctation of aorta Hormonal oral contraceptives Thyroid
Why should dietary salt restriction be a treatment of hypertension
because high renin and angiotensin levels lead to excess sodium retention
What is hyponatremia
Extracellular fluid sodium<135mmols/l
Symptoms of mild hyponatremia
Loss of energy and fatigue
Confusion
Muscle weakness
Symptoms of severe hyponatremia
Nausea and vomiting Headaches Spasms Restlessness and irritability Seizures Coma (all due to brian swelling)
Suspected reasons so many diabetes patients are hypertensive?
Diabetes damages kidneys and induces excess renin release
What causes the link between obesity and hypertension? (3)
1- obesity increases renal renin release, angiotensin formation and sodium retention
2- high levels of leptin due to increased fat cells increase sympathetic vasoconstriction
3- obesity is associated with hyperinsulinaemia
First line for hypertensive diabetics?
ACE inhibitors of angiotenis receptor blockers instead of diuretics
First line for hypertensive obese people?
Exercise
First line for white people or people <55 years old?
ACE inibitor or low cost angiotensin II receptor blocker
First line for black or african caribbean and >55 years old>
Calcium channel blocker
When may beta blockers be prescribed (usually not first step)
Younger people, particularly if intolerant to ACE inhibitors and angiotensin II receptor antagnosis,
women of child bearing potential
people with increased sympathetic drive
