Hypertension Flashcards
What is the target BP in >80s?
150/90
What is stage 1 HT?
> 140/90 (>135/85 ABPM)
What is stage 2 HT?
> 160/100 (ABPM >150/95)
What is stage 3 HT?
> 180/110 (ABPM >diastolic 110)
What is white coat HT?
high BP in clinical setting but normal at home
What must be done to confirm HT?
if BP > 140/90 offer ABPM this must be done to confirm the diagnosis
Where is HT in higher incidence undeveloped/developed countries?
developed
Name the clinic signs and tests used to assess risk?
test for proteinuria take bloods fundoscopy ECG Age
What tests are useful for detecting LVH + strain?
ECHO
MRI
What treatment is offered after stage 1?
lifestyle advice
What treatment is offered after stage 2?
HT treatment
Combination/monotherapy is better in HT?
combination
How is benign HT found ?
asymptomatic accidental finding on health checks
Every 10mmHG of diastolic above 85 ____ risk of MI
doubles
Every 8mmHg of diastolic pressure above 85 doubles risk of _____
stroke
What does HT do to BV walls?
Causes blood vessel wall changes in small arteries and arterioles (also retina and kidneys) Thickens Media (smooth muscle)
What is HT arteriosclerosis?
plasma proteins forced into the vessel wall
What is Malignant HT? Is it Life threatening?
Life threatening (diastolic >130-140)
How does Malignant HT develop and what does it require?
develops from benign primary or secondary, requires urgent treatment
What doe Malignant HT cause?
cerebral oedema
acute renal failure, acute HF
headache and cerebral haemorrhage
blood vessels show fibrinoid necrosis
What is the risk with Pregnant women and HT?
Pre-Eclampsia = hypertension and proteinuria
. Increased maternal and foetal morbidity and mortality.
What drugs are pregnant women given for HT?
beta blockers
Explain the treatment plan for a HT patient under 55yrs of age?
1 ACE/ARB 2 ACE/ARB + Ca2+ Channel Blocker 3 ACE/ARB + Ca2+ + thiazide 4 refer lifestyle advice
Explain treatment plan for HT over 55 years?
ca2+ channel blocker or thiazide diuretic
Why may a patient over 55 be put on a thiazide drug instead of Ca2+?
Ca2+ causes ankle oedema
Thiazide reduces this and also if the patient has Heart FAILURE
What is a side effect of Thiazide/
can cause gout
Name the investigation to test for urine and what you are looking for in HT?
urinalysis
protein or blood
What are you looking for in ECG for HT?
ventricular hypertrophy
What is the test for the eye in HT and what are we looking for?
fundoscopy
papilloedema
haemorrhages and exudates
Name some causes of secondary HT?
Cushing’s syndrome
Conn’s Syndrome
Phaeochromocytoma
Renal Disease
What are the complications of HT?
Cerebrovascular disease
Retinopathy
Kidney disease
How can too much salt lead to hypertension?
Increases release of aldosterone, which causes salt and fluid retention [part of RAAS]
How can renal disease lead to hypertension?
Reduced renal flow causes excess renin release, ultimately leading to fluid overload
Conn’s syndrome is an endocrine cause of hypertension - what happens?
Excess production of aldosterone, leading to fluid overload
What blood vessel changes occur in hypertension?
Thickening of media (smooth muscle) layer
Arteriosclerosis (hardened arteries)
