Hypertension Flashcards
What is an ambulatory blood pressure device used for?
Measures blood pressure throughout the day to get a better idea of fluctuations and get a more accurate reading without white coat hypertension
What are the symptoms of left ventricular hypertrophy?
Pulmonary oedema
What are the symptoms of right ventricular hypertrophy?
Peripheral oedema
How do ACE inhibitors work?
. Inhibits ACE, less angiotensin I converted to angiotensin II
. Less aldosterone produced (more salt and water excreted) and vasodilation (from bradykinin, which also produces potassium) = lowers BP
Why can ACE inhibitors induce a dry cough? Why is this and what can be done if the cough becomes too bad?
. Can develop dry cough due to increased bradykinin (bradykinin stimulates vasodilation, but can also cause dry cough)
. If cough too bad, can switch to calcium-channel blocker instead
What is the danger of increased blood potassium (hyperkalaemia)?
Increased potassium levels can lead to cardiac arrhythmias
Why are sodium and potassium levels measured before giving ACE inhibitors?
ACEIs often increase potassium levels in the body, which can be dangerous (e.g. can cause cardiac arrhythmias)
Can patients with hypertension use Ibuprofen?
It isn’t advised because NSAIDs induce fluid-retention, which exacerbates hypertension. Hypertensive patients should use paracetamol for pain relief instead.
How can you check for ventricular hypertrophy using an ECG?
Check height of QRS complex to see force of ventricular contraction
How can you check for sinus rhythm using an ECG?
Check R-R wave intervals (see if they’re consistent, which shows consistent ventricular contraction)
How can you test for excessive alcohol consumption using a liver function test?
High gamma-glutamyl transpeptidase level (GGT), as this is an enzyme found in liver cells that ‘leaks out’ when there’s liver damage
Why is it not advised for people on ACE-inhibitors to eat Lo-Salt?
. Lo-Salt has a high concentration of potassium
. ACEIs can increase potassium levels, so adding more potassium risks hyperkalaemia leading to cardiac arrhythmia
How can ACE inhibitors lead to hyperkalaemia?
. Less angiotensin II produced, so less aldosterone produced
. Aldosterone normally increases excretion of potassium, so ACEIs cause more potassium to be retained
What does simvastatin do?
Reduces cholesterol by inhibiting HMG-CoA reductase
Why should simvastatin be taken at night?
Cholesterol synthesis (in liver) is greatest at night
