Hypertension Flashcards
What is Hypertension
Clinical Blood pressure that is >140/90mmHg
What can happen if resting blood pressure increases by 2mmHg
7% increase in mortality from IHD
10% increases mortality risk from stroke
What is essential/primary Hypertension
Hypertension with no direct cause
What is secondary hypertension
Hypertension with a direct cause
What percentage of total hypertension cases are secondary
5-10%
When is secondary hypertension considered
In young patients with an acute onset of hypertension and suggesting Hx
What are risk factors for Hypertension
Smoking Diabetes Renal disease Male (x2) Hyperlipidaemia MI or stroke LVH (x2) Genetic Environment Weight Alcohol Race
What happens to blood pressure when you age
It increases due to decreased arterial compliance
How likely are you to get hypertension if
1) Your parents have it
2) Your siblings have it
1) Quite likely
2) Very Likely
What effect does reducing sodium intake have on normotensive
It has little effects
What effect does reducing sodium intake have on hypertensives
It significantly reduces BP
What effect does alcohol have on BP
A little bit of alcohol decreases BP
Large amounts of alcohol increases BP
What happens to Blood pressure if alcohol cessation occurs
Blood pressure drops by 5/3mmHg over days/weeks
What percentage of hypertension is attributable to obesity
30%
What will happen to BP if weight is lost
BP will decrease
What effect does losing 9kg of body weight have on people with
1) Untreated hypertension
2) Treated hypertension
1) can reduce by 19/18mmHg
2) can reduce by 30/21mmHg
What the relationship with birthweight and hypertension
The lower the birth weight - the higher the chance of developing hypertension and heart disease
What is the relationship between Africo-Caribbean and hypertension
Africo-Caribbean’s have higher blood pressure than caucasians as they are genetically selected to be salt retainers. (low renin) They respond differently to changes in diet (western diet).
What are the causes of secondary hypertension (x6)
Renal disease Drug induced Pregnancy Endocrine Vascular Sleep Apnoea
What types of renal disease cause hypertension
Chronic pyelonephritis (pyogenic infection) Fibromuscular dysplasia (abnormal growth artery wall) Renal artery stenosis (stenosis of kidney arteries) Polycystic kidneys (lots of fluid filled sacs)
What drugs can induce hypertension
Non steroidal anti-inflammatory drugs (block prostaglandin synthesis so increase BP)
Oral contraceptive
Corticosteroids (sodium retention)
What is pre-eclampsia
Pregnant woman has Increased BP and protein in urine
around 20 weeks
Important to treat as can develop into eclampsia (seizures)
What are some endocrine causes of hypertension
Conns syndrome Cushing Phaeochromocytoma Hypo/Hyper thyroidism Acromegaly
What is Conns syndrome
adrenal glands make too much aldosterone
What is cushings
To much cortisol
What is a Phaeochromocytoma
Tumour of the adrenal gland - increased production of adrenaline and noradrenaline
What vascular problem can cause secondary hypertension
coarctation of the aorta
