Hypertension

Question 1

In terms of clinic BP reading, what is Stage 1 HTN?

Answer 1

≥140/90 mmHg

Question 2

In terms of ABPM reading, what is Stage 1 HTN?

Answer 2

≥135/85 mmHg

Question 3

In terms of clinic BP reading, what is Stage 2 HTN?

Answer 3

≥160/100 mmHg

Question 4

In terms of ABPM reading, what is Stage 2 HTN?

Answer 4

≥150/95 mmHg

Question 5

What SBP and DBP indicates severe HTN?

Answer 5

SBP ≥180 mmHg

DBP ≥110 mmHg

Question 6

When should you offer medical management for stage 1 HTN?

Answer 6

• if the patient is <80 AND
• if they have any of: target organ damage; established cardiovascular disease; renal disease; diabetes; ≥10% 10-year cardiovascular risk

Question 7

How should stage 2 HTN be managed?

Answer 7

Offer medical management to anyone with stage 2 HTN regardless of age

Question 8

A 50 y/o goes to GP for a routine check-up, and his BP is found to be 162/110. He comes back the next day for review, and ABPM shows his BP to be 154/98. How should this patient be managed?

Answer 8

• lifestyle advice

- offer ACE-I or ARB

Question 9

A 65 y/o M with T2DM goes to the diabetic clinic for review and his BP is found to be 147/97. ABPM reading is 140/88. How should this patient be managed?

Answer 9

• lifestyle advice

- Offer ACE-I or ARB

Question 10

A 89 y/o F with no PMH is found to have a BP clinic reading of 140/90. ABPM reading shows her BP to be 146/87. How should this patient be managed?

Answer 10

• Give lifestyle advice

Question 11

49 y/o African woman has her BP measured in clinic and it is found to be 163/100. ABPM monitoring shows that her BP is 160/105. She has no relevant PMH. How should this patient be managed?

Answer 11

• lifestyle advice

- Offer CCB

Question 12

A 67 y/o M with PMH of T2DM and 1 previous MI is taking the following medication for his hypertension: candesartan, amlodipine and indapamide. In clinic his BP is 167/98 mmHg. Blood tests show that potassium is 3.9 mmol/L. What drug should this patient be given to control their HTN?

Answer 12

Low-dose spironolactone

Question 13

A 70 y/o F with PMH of CKD and COPD is taking the following medication for her hypertension: candesartan, amlodipine and indapamide. In clinic her BP is 158/97 mmHg. Blood tests show that potassium is 4.7 mmol/L. What drug should this patient be given to control their HTN?

Answer 13

Add an alpha- or beta-blocker t

Question 14

What is the BP target for a person <80 y/o?

(i) Clinic BP
(ii) ABPM

Answer 14

(i) 140/90 mmHg

(ii) 135/85 mmHg

Question 15

What is the BP target for a person >80 y/o?

(i) Clinic BP
(ii) ABPM

Answer 15

(i) 150/90 mmHg

(ii) 145/85 mmHg

Question 16

Define malignant hypertension.

Answer 16

• BP >180/110

- AND presence of signs of papilloedema/retinal haemorrhages/exudates