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CVS > Hypertension > Flashcards

Hypertension Flashcards

1
Q

Definition?

A

Persistently raised blood pressure, usually above 140/90.

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2
Q

Risk Factors?

A
  • Obesity
  • Exercise
  • Alcohol intake
  • Metabolic syndrome
  • DM
  • Age> 60
  • Sex
  • Ethnicity
  • Genetic factors
  • SE-class
  • Anxiety and stress
  • Sleep apnoea
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3
Q

Common differentials?

A
  • Essential HT-headaches, vision, nosebleeds or neuro symptoms
  • Renal artery stenosis-bruits, PVD
  • CKD-pain, nausea, urnary problems
  • Obstructive uropathy-flank pain, inflammation
  • Obstructive sleep apnoea
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4
Q

Uncommon differentials?

A
  • Coarctation of aorta-congenital
  • Pre-eclampsia
  • Glomerulonephritis/nephrotic /PCKD
  • Phaeochromocytoma, hyperaldosteronism, Cushing’s HT,HPT
  • Alcohol/drug use
  • White coat/masked HT
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5
Q

Epidemiology?

A

Age: older
Sex: Men
Ethnicity: Black/AC
Prevalence: more than 50% of over 60’s

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6
Q

Aetiology?

A
  • Primary-genetic or environmental factors-unknown

* Secondary-RECENT-renal, endocrine, coarctation of aorta, oestrogen, neuro, treatment

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7
Q

Clinical Presentation?

A
  • Asymptomatic until signs of end-organ damage
  • Headaches esp in early morning
  • Dizziness
  • Tinnitus
  • Blurred vision
  • Flushed appearance
  • Epistaxis
  • Chest discomfort, palpitations, strong bounding pulse
  • Nervousness
  • Fatigue/sleep disturbances
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8
Q

Pathophysiology?

A
  • Vascular changes
  • Remodelling and hypertrophy
  • Plaque build up and thickening of the wall causes endothelial dysfunction/hypertrophy-narrow lumen and build up of luminal pressure-end organ damage
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9
Q

Investigations first line?

A

BP and exam
Take 3 and record lowest
If bt 140/90 and 180/20-ABPM/HBPM

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10
Q

Investigations second line?

A 
Assess for target organ damage
Haematuria, Al:Cr, HbA1c, electrolytes, eGFR,
Retinal exam
ECG
Specialist referral
Assess CVD Risk-QRISK
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11
Q

What is stage 1?

A

140/90 to 159/99 and ABPM/HBPM from 135/85 to 149/94

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12
Q

What is stage 2?

A

160/100 to 180/120 and ABPM/HBPM of 150/95

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13
Q

What is stage 3?

A

180/20 or higher

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14
Q

First line of management?

A

Lifestyle advice

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15
Q

First line of pharmacological management?

A

Under 55 or T2DM- ACE inhibitor and Ang IIR blocker

Over 55/AC- CCB

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16
Q

Second line of pharmacological management?

A

A + C/ A+D

17
Q

Third line of pharmacological management?

A

A +C + D

18
Q

Fourth line of pharmacological management?

A

A+C+D+ a or b blocker

19
Q

Prognosis?

A

Every 10 mmHg reduced reduces CAD and stroke risk by 17 and 27% and HF by 28%
Risk increases as BP does
And 13% less all-cause mortality

20
Q

Complications?

A 
HF
CAD
Stroke
CKD
PAD
Vascular dementia
Disability

CVS (30 decks)

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