Hypertension Flashcards
What BP is considered hypertensive?
> 140/90mmHg
What are the secondary causes of HTN?
Renal disease
- Glomerulonephritis
- polyarteritis nodosa
- PKD
Endocrine disease
- Cushings
- Conn’s
- Acromegaly
- hyperparathyroidsim
- Phaeochromocytoma
Others
- Coarctation of the aorta
- Pregnancy
- Steroids
- MAOIs
What are S&S of HTN?
- commonly asymptomatic
- Headache
- Visual change e.g Decreased acuity or floater or papilloedema
- SOB suggestive of underlying CHF or CAD
- Angina indicating CAD
What tests should be done in HTN?
Fasting metabolic panel with eGFR - may show renal insufficiency, hyperglycaemia etc . Looks for metabolic syndrome
Lipid Panel
ECG
Urinalysis - ?kidney damage
U&E’s - hypokalaemia in Conn’s or increased calcium in hyperparathyroidism
Plasma renin and aldosterone
How is HTN managed in patients <55 or with T2DM?
step 1 = ACEi or ARB (A)
Step 2 = ACEi/ARB + Calcium channel blocker OR ACEi/ARB + thiazide diuretic (A+C or A+D)
Step 3 = ACEi + CCB + Diuretic (A+C+D)
Step 4 = confirm resistant HTN with ABPM, assess for postural hypertension, consider spironolactone or B-blocker and refer to specialist
How is HTN managed in patients >55 or Afro-carribbean?
Step 1 = C
Step 2 = C+A or C+D
Step 3 = C+A+D
Step 4 = confirm resistant HTN with ABPM, assess for postural HTN, consider spiro + beta blocker, specialist referral
what are the side effects of thiazide diuretics e.g chlorothiazide or chlorthalidone
hypokalaemia, hyponatraemia, impotence
what are the SE’s of calcium channel blockers such as verapimil and nifedipine?
Flushes, Fatigue, gum hyperplasia, ankle oedema
what are the SEs of ACEi e.g ramipril, enalapril, captopril?
dry cough, hyperkalaemia, renal failure, angio-oedema
what are the SE’s of angiotensin receptor blockers such as candesartan, losartan, valsartan?
Vertigo, urticaria, pruritis
what are the SE’s of beta blockers such as bisoprolol, propanolol
Bronchospasm, HF, Cold peripheries, lethargy
