Hypertension

Question 1

What is the main driver of hypertension risk?

Answer 1

Age

Question 2

Assessment for hypertension?

Answer 2

History Family history Smoking CV examination Repeated BPs Examine fundi?

Question 3

Risk factors in risk factor calculator?

Answer 3

Age Gender Family member with CVD under 60 Chronic kidney disease Suffered atrial fibrillation? Cholesterol (HDL done separately) Diabetes Blood pressure treatment Systolic BP Smoker?

Question 4

Other risk factors of hypertension?

Answer 4

Left ventricular hypertension Creatinine raised Albuminuria/microalbuminuria Retinoptathy

Question 5

What does CV mortality risk double with?

Answer 5

Each20/10mmHg of blood pressure Increase

Question 6

Hypertension is likely to affect most of us. True or false?

Answer 6

True

Question 7

Avoidable deaths most popular causes?

Answer 7

Tobacco Hypertension Alcohol Cholesterol Obesity Low fruit and veg Sloth Illicit drugs Unsafe sex

Question 8

Hypertension definition?

Answer 8

The level of Blood pressure where treatment can do more harm than good

Question 9

Hypertension must be measured using?

Answer 9

ABPM (Ambulatory Blood Pressure Monitoring ) - When your bood pressure is being measured moving around , living every day life over usually 24 hours. or HBPM - Home measuring BP

Question 10

When using ABPM to confirm diagnosis ensure that you…?

Answer 10

Have at least 2 measurements per hour during the persons usual walking hours

Question 11

When using HBPM to confirm a diagnosis you must ensure that…?

Answer 11

There is 2 consecutive seated measurements, 1 minute apart BP is recorded twice a day for at least 4 days preferably 7 Measurements on the first day are discarded and average is taken of the rest

Question 12

Definition of stage 1 hypertension?

Answer 12

Clinical BP is 140/90 mmHg or higher ABPM or HBPM daytime average is 135/85mmHg or higher

Question 13

Definition of stage 2 hypertension?

Answer 13

Clinic BP of 160/100mmHg or higher ABPM or HBPM daytime average is 150/95mmHg or higher

Question 14

Definition of severe hypertension?

Answer 14

Clinic BP is 180mmHg or higher Clinic diastolic BP is 110mmHg or higher

Question 15

Assessing cardiovascular risk protocol?

Answer 15

Estimation of CV risk to discuss prognosis and healthcare options - offer to - -Test urine for presence of protein -Take blood to measure glucose, electrolytes, creatinine, estimated glomerular filtration rate and cholesterol -Examine fundi for hypertensive retinopathy - Arrange 12- lead ECG

Question 16

Assessment for hypertension?

Answer 16

Medical History Family History of premature CV disease Smoking CV examination Repeated BPs Examine fundi

Question 17

Grade 1 hypertensive retinopathy?

Answer 17

Slight or modest narrowing of the retinal arterioles with arteriovenous ratio >_1:2

Question 18

Grade 2 hypertensive retinopathy?

Answer 18

Modest to severe narrowing of the retinal arterioles (focal or generalized), with an arteriovenous ratio

Question 19

Grade 3 hypertensive retinopathy?

Answer 19

Bilateral soft exudates or flame shaped haemorrhages

Question 20

Grade 4 hypertensive retinopathy?

Answer 20

Bilateral optic nerve oedema

Question 21

When monitoring treatment in patients?

Answer 21

Use clinic blood pressure measurements to monitor response to treatment . Aim for target pressure below -140/90mmHg in people aged under 80 - 150/90 in people over 80

Question 22

Is BP genetically determined?

Answer 22

Twin studies show 30-50% of BP variability is genetically determined

Question 23

Common causes of secondary hypertension?

Answer 23

Renal disease Obstructive sleep apnoea Aldosteronism Reno-vascular disease

Question 24

Uncommon causes of secondary hypertension?

Answer 24

Cushing’s Pheochromocytoma Hyperparathyroidism Aortic coarctation Intracranial tumor

Question 25

Different studies ideas on treatment of renal artery stenosis?

Answer 25

Stenting is no benefit Revascularization has no benefit- substantial risk

Question 26

What grade 4 retinopathy looks with the 4 signs

Answer 26