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Cardio > Hypertension > Flashcards

Hypertension Flashcards

1
Q

What is stage 1 hypertension?

A

More than or equal to 140/90mmHg clinic BP

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2
Q

What is stage 2 hypertension?

A

More than or equal to 160/100mmHg clinic BP

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3
Q

What is stage 3 hypertension?

A

Clinic systolic BP greater than or equal to 180mmHg and/or diastolic BP greater than or equal to 110mmHg

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4
Q

What can hypertension be divided into?

A

Primary (Essential) or secondary

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5
Q

What factors can be involved in causing primary hypertension?

A
  • Genetic susceptibility
  • Excessive sympathetic nervous system activity
  • Abnormalities of Na+/K+ membrane transport
  • High salt intake
  • Abnormalities in renin-angiotensin-aldosterone system
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6
Q

What is secondary hypertension most commonly caused by?

A

Renal disease or pregnancy

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7
Q

What is the most common cause of secondary hypertension?

A

Chronic Kidney Disease

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8
Q

What is the most common cause of CKD?

A

Diabetes

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9
Q

What endocrine diseases can cause secondary hypertension?

A
  • Cushings syndrome (hypersecretion of corticosteroids results in hypertension)
  • Conns disease (increase aldosterone secretion)
  • Pheochromocytoma (secretes catecholamines which can cause hypersion)
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10
Q

What drugs are associated with causing hypertension?

A

Prescription

  • Corticosteroids e.g. Prednisolone
  • Cyclosporin
  • Erythropoietin
  • Some types of the contraceptive pill

Non-prescription

  • Alcohol
  • Amphetamines
  • Ecstasy and cocaine
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11
Q

With hypertension what effects are there on the vessel?

A
  • Accelerates atherosclerosis
  • Causes the thickening of the media of muscular arteries
  • Smaller arteries and arterioles especially affected
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12
Q

What effect can hypertension have on the heart?

A

Major risk factor for IHD

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13
Q

What effect can hypertension have on the nervous system?

A

Intracerebral haemorrhage which is a frequent cause of death

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14
Q

What effect can hypertension have on the kidneys?

A
  • Can be the cause or result of renal disease
  • Kidney size is often reduced and small vessels show intimal thickening and medial hypertrophy and the numbers of sclerotic glomeruli are increased
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15
Q

How does malignant hypertension present?

A
  • Markedly raised diastolic BP and progressive renal disease.
  • Renal vascular changes are prominent and there is usually evidence of acute haemorrhage and papilloedema
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16
Q

What is papilloedema?

A

Optic disc swelling caused by increase intracranial pressure

17
Q

What are the consequences of malignant hypertension?

A
  • Cardiac failure with left ventricular hypertrophy and dilatation
  • Blurred vision due to papilloedema and retinal haemorrhages
  • Haematuria and renal failure due to fibrinoid necrosis of glomeruli
  • Severe headache and cerebral haemorrhage
18
Q

What are the risk factors for hypertension?

A
  • Age - risk increases as you age
  • Race - hypertension is more common in blacks
  • Family history - hypertension runs in families
  • Overweight and obese
  • Little exercise
  • Smoking
  • Too much salt in diet
  • Alcohol
  • Diabetes
  • Stress
  • Other medicines - oral contraceptive, SNRI antidepressants
19
Q

What investigations would you do in hypertension and why?

A

Looking for end organ damage and patients with secondary causes of hypertension.

  • ECG
  • Urinalysis
  • Blood tests
  • Echocardiogram
20
Q

What is the non-pharmacological treatment for hypertension?

A
  • Change diet: High consumption of vegetable and fruits and low-fat diet
  • Regular physical exercise
  • Reduce alcohol intake
  • Reduce salt intake - Lose weight - Stop smoking
    (Lose 1kg in weight = can reduce 1 tablet)
21
Q

What is the pharmacological treatment pathway for hypertension?

A

ACD pathway
A - ACE inhibitor
C - Calcium channel blocker
D - diuretic

22
Q

What is the first line treatment for someone with hypertension under the age of 55 as apposed to over the age of 55?

A
  • Under 55 = ACE inhibitor

- Over 55 = Calcium channel blocker

23
Q

Give an example of an ACE inhibitor?

A

Ramipril

24
Q

Give an example of a calcium channel blocker?

A

Amlodipine

25
Q

Give an example of a thiazide diuretic and a loop diurectic?

A 
Thiazide = Bendroflumethiazide
Loop =  Furosemide

Cardio (9 decks)

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