Hypertension

Question 1

what are secondary causes of hypertension?

Answer 1

1. renal artery disease (if unresponsive to tx consider renal artery stenosis) 2. obesity 3. pregnancy/pre-eclampsia 4. Endocrine - particularly conns syndrome

Question 2

What is stage 1 HTN? what should you do at this stage?

Answer 2

140/90 or 135/85 ambulatory - give lifestyle advice

Question 3

what is stage 2 HTN?

Answer 3

160/100 or 150/95 ambulatory

Question 4

What is stage 3 hypertension?

Answer 4

180/120

Question 5

What investigations should you do with all new patients diagnosed with HTN?

Answer 5

look for end organ damage 1. renal: urine albumin: creatinine ratio, urine dipstick (haematuria) 2. Bloods for HbA1c, renal function and lipids 3. Fundus examination for hypertensive retinopathy 4. ECG for cardiac abnormalities

Question 6

Who should be offered medical management?

Answer 6

1. All with stage 2 hypertension 2. >80 with clinic BP 150/90 3. <80 but with end organ damage, CV or renal disease, diabetes or 10 year CVD risk >10%

Question 7

How do you manage hypertension

Answer 7

Question 8

What is the target blood pressure in htn?

Answer 8

• <80 years old - <140/90
• >80 years old - add 10 to systolic value