Hypertension Flashcards
What is stage 2 hypertension?
clinic BP ≥ 160/100 mmHg + ABPM ≥ 150/95mmHg, treat all
What is step 1 drug treatment?
<55 years old - ACE inhibitor - ARB if ACE inhibitor isn’t tolerated, ≥55 years old/black African/black Caribbean - CCB - thiazide like diuretic if CCB isn’t suitable
What is stage 1 hypertension?
clinic BP ≥140/90mmHg + ABPM daytime average ≥135/85 mmHg, treat if high CVS risk, diabetic or end organ damage
What does malignant hypertension cause?
cerebral oedema, acute renal failure, acute heart failure, headache and cerebral haemorrhage, fibrinoid necrosis of blood vessels, endarteritis proliferans of blood vessel walls - narrows lumen
What is step 4 drug treatment?
resistant hypertension - spironolactone
What does benign hypertension lead to?
left ventricular hypertrophy, congestive cardiac failure, increases atheroma, increases aneurysm rupture, renal disease
How does renal disease cause hypertension?
reduced renal blood flow - excess renin release - salt and water overload
What is the sign for cerebral oedema?
papilledema - swelling of optic disc
What is primary hypertension?
unknown case, most common, genetic factors, salt intake, protein intake, renin-angiotensin system, sympathetic activity
What is step 2 drug treatment?
CCB + ACE inhibitor/ARB - ARB preferred in black African or Caribbean - thiazide like diuretic if CCB isn’t suitable
What is benign hypertension?
often primary, asymptomatic
What is malignant hypertension?
often secondary, life-threatening, diastolic pressure >130mmHg
What are the lifestyle interventions?
reduce sodium and caffeine intake, weight reduction, exercise, reduction of alcohol consumption in heavy drinkers, stop smoking
What is step 3 drug treatment?
ACE inhibitor/ARB + CCB + thiazide like diuretic
What is severe hypertension?
clinic systolic BP ≥ 180 mmHg or clinic diastolic BP ≥ 110 mmHg, start treatment immediately
