hypertension Flashcards
define hypertension
a clinic reading persistently above 140/90mmHg
what is malignant hyperthyroidism?
BP > 200/130 mm Hg
what is the difference between primary and secondary hypertension?
- primary means no single disease causing it
- secondary means there is a single cause
epidemiology of hypertension?
- very common
- primary is 90% of all cases
examples of secondary causes?
- refer to table
- renal
- endocrine
- other
what are the stages of hypertension?
- Clinic BP >= 140/90 mmHg
- Clinic BP >= 160/100 mmHg
- Clinic systolic BP >= 180 mmHg
what is ABPM?
Ambulatory blood pressure monitoring. 2 measurements per hour for waking hours
what is HBPM?
Home blood pressure monitoring. 2 measurements morning and evening for 4 days
what is idiopathic intercranial hypertension?
hypertension is a condition in which there is raised intracranial pressure of an uncertain cause. It’s often seen in young overweight females, and associated with certain drugs e.g. OCP, steroids, tetracycline, vitamin A and lithium. Treated by lumbar punctures and acetazolamide and weight loss*
presenting symptoms of hypertension
- often asymptomatic
what are symptoms of malignant hypertension?
- Scotomas
- blurred vision
- headaches
- seizures
- N and V
- heart failure
which signs might be realised?
- BP recording
- Renal artery bruit
- Fundoscopy
which investigations should be conducted?
- bloods Us and Es HbA1c lipids - urine dip - ECG - ABPM
what are the target BPs? for non diabetic, T2DM, T1DM, T1DM with protein?
- Non-Diabetic: 140/90
- T2DM = 140/90
- T1DM = 135/85
- T1DM with albuminuria = 130/80
BP over and under 80 years?
less than 80 = 140/90
over 80 = 150/90
medical management plan for hypertension?
refer to NICE table
conservative advice for hypertension?
o Stop smoking
o Lose weight
o Reduce alcohol intake
o Reduce dietary sodium
how to manage severe hypertension?
o Atenolol
o Nifedipine
how to manage Malignant Hypertension Management?
o IV beta-blocker (e.g. esmolol)
o Labetolol
o Hydralazine sodium nitroprusside
o Must NOT be lowered too fast
example of ACE inhibitor? CCB? thiazide like diuretic? ARB?
- ACE inhibitor = ramipril
- CCB = amlodipine
- thiazide like diuretic = indapamide
- ARB = losartan
complications of hypertension?
- Heart failure
- Coronary artery disease
- Cerebrovascular accidents
- Peripheral vascular disease
- Emboli
- Hypertensive retinopathy
- Renal failure
- Hypertensive encephalopathy
- Posterior reversible encephalopathy syndrome (PRES)
prognosis for patients with hypertension?
- good prognosis
- uncontrolled is associated with increased mortality
