Hypertension

Question 1

Hypertension definition

Answer 1

A blood pressure level above which investigation and treatment do more good than harm

Question 2

Types of hypertension

Answer 2

Primary (essential) hypertension

Secondary hypertension

Pseudo-resistant hypertension

Resistant hypertension

Question 3

Primary hypertension epidemiology

Answer 3

95% of hypertensive patients

Question 4

Primary hypertension stages

Answer 4

Stage 1 - under 140/90mm/Hg

Stage 2 - 140/90-179/119 mm/Hg

Question 5

Secondary hypertension causes (8)

Answer 5

Conn’s syndrome (primary hyperaldosteronism)

Renovascular disease

Obstructive sleep apnoea

CKD

Pheochromocytoma

Aortic coarctation

Cushing’s disease

Hyperparathyroidism

Question 6

Pseudo-resistant hypertension causes

Answer 6

White-coat hypertension
Inaccurate measurement methods (e.g. incorrect cuff-size)
Poor adherence to treatment

Question 7

Resistant hypertension definition

Answer 7

Patient BP is not controlled despite treatment

Question 8

Hypertension epidemiology

Answer 8

Kills >11million people/year globally

Question 9

Management of HTN

Answer 9

ACEi/ARBs for left ventricular systolic dysfunction

Beta-blockers for any ischaemic event/arrhythmias

Loop diuretics for congestive symptoms

Question 10

Hypertensive complications - the heart (7)

Answer 10

Left ventricular hypertrophy

Left atrial abnormalities

Myocardial ischaemia

Arrhythmias

Heart failure

Increase risk of cardiac event

Aortic dissection/aneurism

Question 11

Hypertensive complications - the brain

Answer 11

Stroke (higher BP leads to greater chance of stroke)

HTN = best predictor of stroke than any other risk factor

Question 12

Hypertensive complications - the kidney

Answer 12

Hypertensive kidney disease

End stage renal disease

Question 13

Hypertensive complications - the eye

Answer 13

Hypertensive retinopathy