Hypertension Flashcards
What is white coat hypertension?
Elevated clinic pressure but normal ABPM
What is masked hypertension?
Opposite of white coat
What is malignant or accelerated phase hypertension?
A rapid rise in BP leading to vascular damage
What is primary or essential hypertension?
Cause unknown
What is secondary hypertension?
Due to a known cause
What can cause secondary hypertension?
ROPE Renal disease Obesity Pregnancy Endocrine - Conn's
What signs/symptoms indicate accelerated phase HTN?
Severe HTN (>200/130), bilateral retinal haemorrhages and exudates, papilloedema, headache, visual disturbance
What investigations would you do to confirm diagnosis?
24 h ABPM or home BP monitoring
What end-organ damage can occur?
Renal failure, CV complications, HTN retinopathy
How would you look for CV complications?
ECG
How would you look for renal failure?
A:CR, dipstick, bloods
What lifestyle changes would you advise?
Stop smoking, low-fat diet, reduce alcohol, reduce salt, increase exercise, reduce weight if obese
When is CCB first choice?
> 55 or black at any age
When is ACE-i or ARB first choice?
<55
What therapy is added for dual therapy?
The first line not used or a thiazide-like diuretic
What triple therapy is used?
ACEi + CCB + Thiazide-like diuretic
How would you manage malignant HTN?
Controlled reduction of BP over days, avoiding sudden drops in BP. Bed rest
What BP is diagnostic?
> 140/90 in clinic or >135/85 with ABPM or home readings
What are risk factors for HTN?
High caffeine consumption, sedentary lifestyle, smoking, Type A personality, Afro-Caribbean
Give an example of an ACEi
Ramipril
Give an example of a CCB
Amlodipine
Give an example of a thiazide-like diuretic
Bendroflumethiazide
Give an example of an ARB?
Candesartan
What is stage I?
> 140/90
What is stage II?
> 160/100
What is severe HTN?
> 180/110
