Hypertension Flashcards
What is the most common cause of hypertension?
Primary= 95% cases
What are the types of hypertension?
Primary= idiopathic Secondary= caused by renal disease, obesity, pregnancy, endocrine..
What are the risk factors for hypertension?
>65yo Obesity FH Inactive Smoking High sodium diet DM Renal disease
What is stage 1 hypertension?
Clinic >140/90
ABPM >135/85
What is stage 2 hypertension?
Clinic >160/100
ABPM >150/95
What is stage 3 hypertension?
> 180 or >110
What is the First step management of hypertension?
<55= ACEi/ARB
>55, Afro-Caribbean= CCB
What is step 2 f hypertension management?
IF on ACEi/ARB, add CCB or TTD
If on CCB, add ACEi/ARB
What is step 3 of hypertension management?
ACEi/ARB + CCB + TTD
What is step 4 in hypertension management?
ACEi/ARB + CCB + TTD
Test blood K+
-<4.5= spironolactone
->4.5= increase TTD or add BB
What is the first line for management of hypertension in pregnancy?
Labetolol
What antihypertensives can be used in pregnancy?
LAbetolol
Methyldopa
Nifedipine
What are some common complications of hypertension?
IHD Cerebrovascular event Heart failure Hypertensive retinopathy Hypertensive nephropathy
What are the main types of antihypertensives?
ACE inhibitor
Angiotensin receptor blocker
CCB
Thiazide type diuretic
How do ACE inhibitors work?
Competitively inhibit the actions of angiotensin converting enzyme, preventing conversion of angiotensin 1 to angiotensin II
What is an example of an ACEi?
Ramipril
Lisinopril
What are some contraindications for ACEi?
Renal failure
Renal artery stenosis
Hyperkalaemia
Pregnancy
What are some common side effects of ACEi?
Bradykinin cough- niggling cough, worse at night
Oedema
When are ARBs often used?
In place of ACEi where they are not tolerated
What is an example of ARBs?
Candesartan
Losartan
What are the types of CCB?
Rate limiting e.g. verapamil
Vasodilating e.g. amlodipine
What type of CCBs are first one in hypertension?
Vasodilating
What are the side effects of CCBs?
Flushing
Oedema
Headache
How to TTDs work?
Prevent reabsorption of Na
What are the side effects of TTDs?
Hyponatraemia
Hypokalaemia
Dehydration
What is an example of TTDs?
Indapamide
Chlorothiazide