Hypertension

Question 1

Define hypertension

Answer 1

> 140/90 mmHg

>135/85 mmHg ABPM

Question 2

Causes of HTN

Answer 2

1. 90% primary, aetiology unknown
2. Endocrine disease: Conn’s, DM, Cushing’s, hyperthyroidism
3. Renal disease: glomerulonephritis, polycystic kidneys, renovascular
4. Drugs - NSAIDs, corticosteroids, OCP,
5. Lifestyle: obesity, high salt + cholesterol, sedentary lifestyle

Question 3

Signs and symptoms of HTN

Answer 3

1. Asymptomatic
2. Features of underlying disease: renal disease, radiofemoral delay, renal bruits
3. End-organ damage e.g retinopathy

Question 4

Management of HTN (drugs)

Answer 4

1. <55 and not afro-carribean/black african - ACE-i/ARB, if not then CCB
2. ACE-i/ARB +CCB OR thiazide-like diuretic
3. ACE-i/ARB + CCB + thiazide-like diuretic
4. Resistant HTN: add spironolactone if blood potassium <4mmol/L, a-blocker or b-blocker if >4mmol/L

Question 5

Management of HTN (lifetstyle)

Answer 5

1. Lose weight
2. Low salt + fat diet
3. Smoking cessation
4. Reduce alcohol

Question 6

ACE-i

Answer 6

Ramipril, enalapril - SE dry cough

Question 7

ARB

Answer 7

Candesartan

Question 8

CCB

Answer 8

Amlodipine, nifedipine

Question 9

Thiazide-like diuretic

Answer 9

Chlorothiazide