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Cardiology > Hypertension > Flashcards

Hypertension Flashcards

1
Q

What is hypertension?

A

BP > 140/90 mmHg

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2
Q

What is essential hypertension?

A
  • Hypertension with no identifiable underlying cause
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3
Q

What is secondary hypertension?

A
  • Hypertension with an identifiable underlying cause
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4
Q

Identify a vascular cause of secondary hypertension

A
  • Coarctation of the aorta

- Renal artery stenosis

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5
Q

Identify a two renal causes of secondary hypertension

A
  • Chronic pyelonephritis
  • Diabetic nephropathy
  • Glomerulonephritis
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6
Q

Identify three endocrine cause of secondary hypertension

A
  • Primary hyperaldosteronism
  • Phaeochromocytoma
  • Cushing’s Syndrome
  • Acromegaly
  • Hypothyroidism
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7
Q

What is stage 1 hypertension?

A
  • 140/90 to 159/99
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8
Q

What is stage 2 hypertension?

A
  • 159/99 to 179/119
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9
Q

Identify three risk factors for hypertension?

A
  • Increasing age
  • Male gender
  • BAME
  • Smoking
  • Excess dietary salt
  • Excess alcohol
  • Obesity
  • Lack of exercise
  • Anxiety
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10
Q

Identify three complications of hypertension

A
  • Heart failure
  • Coronary artery disease
  • Peripheral arterial disease
  • Chronic kidney disease
  • Stroke
  • Vascular dementia
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11
Q

How is hypertension diagnosed?

A
  • Clinic BP > 140/90

AND

  • ABPM or HBPM > 135/85
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12
Q

Identify 3 investigations of target organ damage

A
  • Fundoscopy
  • ECG
  • Urinalysis
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13
Q

What tool should be used to assess 10 year risk of developing cardiovascular disease?

A
  • QRISK
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14
Q

Identify the criteria for urgent specialist assessment of end organ damage

A
  • Stage 3 hypertension in addition to
  • Retinal haemorrhage or papilloedema
  • New onset confusion, chest pain, signs of heart failure or AKI
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15
Q

What is the first line management of stage 1 hypertension?

A
  • Lifestyle advice
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16
Q

Identify three lifestyle changes

A
  • Healthy diet
  • Regular exercise
  • Low sodium diet
  • Smoking cessation
  • Reduced alcohol
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17
Q

Identify three criteria for commencing antihypertensive drugs in stage 1 hypertensionn?

A
  • Target organ damage
  • Cardiovascular disease
  • Renal disease
  • Diabetes
  • QRISK > 10%
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18
Q

What is the first line treatment for stage 2 hypertension?

A
  • Antihypertensive drugs in addition to lifestyle changes
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19
Q

What is the first line antihypertensive drug for a person under 55?

A
  • ACE inhibitor (ramipril)

- ARB (losartan) if ACE inhibitor is not tolerated

20
Q

What is the first line antihypertensive drug for a person over 55?

A
  • CCB (amlodipine)

OR

  • Thiazide like diuretic (indapamide) if CCB is not tolerated
21
Q

What is the first line antihypertensive drug for a person of African or Caribbean descent?

A
  • CCB (amlodipine)

OR

  • Thiazide like diuretic (indapamide) if CCB is not tolerated
22
Q

What is the first line antihypertensive drug for a person with diabetes?

A
  • ACE inhibitor (ramipril)

- ARB (losartan) if ACE inhibitor is not tolerated

23
Q

What is the second line treatment in hypertension?

A
  • ACE inhibitor + CCB

- ARB instead of ACEI if poorly tolerated or black African or Caribbean

24
Q

What is the third line treatment in hypertension?

A
  • ACE inhibitor + CCB + thiazide diuretic
25
Q

What is the fourth line treatment for hypertension?

A
  • If K+ < 4.5: Spironolactone

- If K+ > 4.5: Alpha blocker or beta blocker

26
Q

What is the target blood pressure for people under 80?

A
  • 140/90 on CBP

- 135/85 on AMBP/HMBP

27
Q

What is the target blood pressure for people over 80?

A
  • 150/90 on CBP

- 145/85 on AMBP/HMBP

28
Q

When should a statin be offered?

A
  • QRISK > 10%
29
Q

Identify three causes of hypertension with hypokalaemia

A
  • Primary hyperaldosteronism
  • Cushing’s syndrome
  • Liddle’s syndrome
  • 11B hydroxylase variant of congenital adrenal hyperplasia
30
Q

What is malignant hypertension?

A
  • Blood pressure greater than 180/120 with signs of retinal haemorrhage and new target organ damage
31
Q

Identify three risk factors for malignant hypertension?

A
  • Inadequately treated hypertension
  • Chronic kidney disease
  • Renal artery stenosis
  • Renal transplant
  • Pregnancy
32
Q

Identify three clinical features of malignant hypertension

A
  • Visual changes
  • Headache
  • Nausea
  • Chest pain
  • Shortness of breath
  • Haematuria
  • Oliguria
  • Nosebleeds
33
Q

Identify three investigations in malignant hypertension

A
  • U&E: Raised urea and creatinine
  • Urinalysis: Protein; RBCs
  • ECG: Ischaemic changes
  • CXR: Pulmonary oedema
34
Q

Outline the management of malignant hypertension

A
  • IV labetalol
  • Reduce BP slowly
  • No more than 25% within 24 hours
  • To prevent acute ischaemia
35
Q

Identify three adverse effects of ACE inhibitors

A
  • Dry cough
  • Hypotension
  • Hyperkalaemia
  • Renal failure
36
Q

What is the dose and administration of ramipril?

A
  • 1.25 - 2.5 mg once daily

- By mouth

37
Q

Identify three adverse effects of dihydropyridines

A
  • Oedema
  • Flushing
  • Headaches
  • Palpitations
38
Q

What is the dose and administration of amlodipine?

A
  • 5 mg once daily

- By mouth

39
Q

Identify three adverse effects of thiazide diuretics

A
  • Hyponatraemia
  • Hypokalaemia
  • Arrhythmia
  • Erectile dysfunction
  • Agranulocytosis
  • Worsening of gout
40
Q

What is the dose and administration of indapamide?

A
  • 2.5 mg once daily

- Orally

41
Q

Identify two adverse effects of spironolactone

A
  • Gynaecomastia

- Hyperkalaemia

42
Q

What is the dose and administration of spironolactone?

A
  • 25 mg once daily

- By mouth

43
Q

Identify three adverse effects of alpha blockers

A
  • Postural hypotension
  • Dizziness
  • Syncope
44
Q

What is the dose and administration of doxazosin?

A
  • 1 mg initially

- By mouth

45
Q

Identify three adverse effects of beta blockers

A
  • Fatigue
  • Cold extremities
  • Headache
  • Nausea
  • Nightmares
  • Impotence
46
Q

Identify a contraindication of beta blockers

A
  • Asthma
47
Q

Identify the dose and administration of atenolol

A
  • 25 - 50 mg once daily

- By mouth

Cardiology (16 decks)

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