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Y1 - Cardiovascular > Hypertension > Flashcards

Hypertension Flashcards

1
Q

What is classed as stage 1 hypertension?

A

Clinic BP of >140/90 and A/HBPM BP of >135/85

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2
Q

What is classed as stage 2 hypertension?

A

Clinic BP of >160/100 and A/HBPM of >150/95

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3
Q

What is classed as stage 3 or severe hypertension?

A

Clinic systolic BP of 180+ or diastolic BP of 120+

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4
Q

What are the causes of hypertension?

A 
None (95%)
Renal (e.g. renal artery stenosis)
Endocrine (e.g. Cushing's)
Drugs (e.g. cocaine)
Raised ICP
Coarctation of the aorta
Pre-eclampsia
Fluid overload
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5
Q

What is the difference between an ABPM and a HBPM?

A

ABPM: assesses daytime and night time BP during routine daily activities over 24 hours
HBPM: assesses blood pressure at specific times during the day and night over a longer period of time

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6
Q

Is ABPM or HBPM usually done?

A

Usually ABPM

HBPM if ABPM is declined or not tolerated

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7
Q

What clinic blood pressure would cause you to start medication immediately?

A

180/120 or higher

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8
Q

What further investigations are done in a hypertensive patient?

A

Urine - haematuria, Albumin:Creatine ratio
Bloods (FBC, U&Es, glucose, lipids)
12 lead ECG
Fundoscopy (hypertensive retinopathy)

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9
Q

What assessment criteria is done in hypertensive patients?

A

10 year cardiovascular risk, e.g. QRISK score

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10
Q

What lifestyle interventions are recommended for hypertensive patients?

A

Exercise
Stop smoking
Limit alcohol, salt and caffeine

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11
Q

What is the management if blood pressure is under 135/85 (A/HBPM)?

A

Check BP at least every 5 years

If evidence of target organ damage consider alternative causes

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12
Q

What is the management if >80 with clinic BP >150/90?

A

Offer lifestyle advice

Consider drug treatment

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13
Q

What is the management of BP 135/85 to 149/94 if the patient is <80 with target organ damage, CVD, renal disease, diabetes or 10 year CVD risk over 10%?

A

Offer lifestyle advice

Discuss starting drug treatment

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14
Q

What is the management of BP 135/85 to 149/94 if the patient is <60 with 10 year CVD risk <10%?

A

Offer lifestyle advice

Consider drug treatment

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15
Q

What is the management of BP 135/85 to 149/94 if the patient is age <40?

A

Offer lifestyle advice

Consider secondary causes and assess benefits and risks of treatment

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16
Q

What is the management if blood pressure is 150/95 or higher?

A

Offer lifestyle advice

Discuss treatment

17
Q

How is hypertension followed up?

A

Offer annual review

18
Q

What is the treatment pathway for a hypertensive patient with type 2 diabetes or is age <55 and not of black African or African-Caribbean family origin?

A
  1. ACEi or ARB
  2. ACEi/ARB + CCB or thiazide-like diuretic
  3. ACEi/ARBB + CCB + thiazide-like diuretic
  4. Consider addition of spironolactone if K+ <4.5 or alpha blocker or beta blocker if K+ >4.5
19
Q

What is the treatment plan for hypertension without type 2 diabetes, where patients are age 55 or over, or black African or African Caribbean family origin of any age?

A
  1. CCB
  2. CCB + ACEi/ARB or thiazide-like diuretic
  3. ACEi/ARBB + CCB + thiazide-like diuretic
  4. Consider addition of spironolactone if K+ <4.5 or alpha blocker or beta blocker if K+ >4.5
20
Q

Which patients are first offered ACE inhibitors?

A

Type 2 diabetes

Age <55 and not black African or African-Caribbean family origin

21
Q

What is used to monitor treatment?

A

Clinic BP

22
Q

What is the blood pressure target for age <80 years?

A

Clinic BP <140/90

23
Q

What is the blood pressure target for age >80 years?

A

Clinic BP <150/90

24
Q

What is the blood pressure target patients with postural hypertension?

A

Base target on standing BP

25
Q

What is the blood pressure target for patients with diabetes?

A

Clinic BP <130/80

Y1 - Cardiovascular (11 decks)

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