Hypertension Flashcards
What is stage 1 HTN?
clinical BP of >140/90
ABPM/HBPM: >135/90
What is stage 2 HTN?
clinical BP of >160/100
ABPM/HBPM: >150/95
What is severe HTN
> 180 systolic or >110 D
What are the complications of HTN?
Neuro: cerebral oedema, brain haemorrhage
Renal: haematuria, proteinuria, progressive kidney disease
Eye: flame shaped haemorrhages, cotton wool spots, papilloedema
What are the causes of HTN?
- Usually idiopathic
- renal disease
- pregnancy
- thyroid disease
- hyperaldosteronism
What does HTN put you at risk of?
HF, CHD, stroke, CKD, PAD, vascular dementia
wHat can be found on examination in HTN?
usually asymptomatic apart from raised BP
What investigations would you do?
- U&E, eGFR - assess renal function
- Urine six - proteinuria + haematuria
- BM - assess for DM
- Serum lipids and cholesterol
- ECG - LVH or myocardial ischaemia
When should anti-hypertensives be offered?
- <80yrs + stage 1 + 1 or more of: target organ damage, established CV damage, renal disease, DM, 10yr CV risk or more w QRISK
- Stage 2 HTN any age
What is the standard treatment of HTN for under 55 or w T2DM?
- ACEi or ARB
- CCB or TLD
- Combo of ACEi/ARB + CCB + TLD
- Spironolactone
Give the standard treatment for afrocaribbean or >55
- CCB
- ACEi or ARB or TLD
- combo of ACEi/ARB + CCB + TLD
What is resistant HTN, what is its treatment?
HTN that doesn’t improve after the usual management
Treat w:
low dose spironolactone if blood K+ 4.5 or less
alpha-blocker or beta blocker if blood K+ >4.5
When is spironolactone contraindicated?
blood K+ >4.5 or reduced eGFR
What is essential htn?
No underlying cause w multifactorial aetiology
What are the blood pressure targets in those under 80yrs?
- Clinic BP <140/90 mmHg
* ABPM/HBPM <135/85 mmHg
