Hypertension and Stroke Flashcards
What is hypertension?
Elevated BP
Describe korotkow sounds?
Systolic pressure = when sounds appear(upper number)
Diastolic pressure = when sounds disappear = bottom number
Generally what level is high BP?
140/90
What is taken into account when diagnosing hyperteniosn?
BP, cardiovascular risk e.g. weight, smoking, exercise
Describe the position of patient when measuring BP?
Sitting
At rest
How many readings should you take when measuring BP?
2
List 6 pathophysiological effects of hypertension?
Bursting effects e.g. cerebral haemorrhage Coronary heart disease Stroke Renal Failure Arteriosclerosis
What type of hypertension is responsible for the majority of hypertension cases?
Essential hypertension
Aetiology of essential hypertension?
Poly-causal
Genetic and environmental (obesity, salt, lack of exercise)
Generally how is essential hypertension diagnosed?
Diagnosis of exclusion
Look at all potential causes of hypertension, if they all come back negative then essential hypertension is diagnosed
Name another type of hypertension - existing in 10% of hypertensive cases?
Secondary hypertension
List 4 indicators of secondary hypertension?
Very high BP, poorly controlled, in the young, medication not controlling it
What are the first 3 things to look at in a patient if you suspect secondary hypertension?
Renal function, electrolytes and patient symptoms
Most common causes of secondary hypertension? (2)
Renal artery stenosis
Endocrine causes e.g. Conn’s or Cushing’s syndrome
What is Cushing’s syndrome?
Excess circulating steroids
What is Cushing’s disease?
primary pituitary disease causing excess circulating steroid
What would an electrolyte test showing low K suggest?
Conn’s syndrome
What is an effect of Cushing’s syndrome?
Obesity with striae (stretch marks)
What part of the body does Conn’s syndrome effect?
Adrenal gland - tumour
Effect of elevated BP?
Heart - increased risk of coronary heart disease, (left ventricular hypertrophy = increased muscle = less space in ventricle), arrhythmia Aortic aneurysm Peripheral vascular disease Cerebral circualtion - stroke Hypertensive encephalopathy Eye changes
Complications of hypertension?
MI, stroke or peripheral vascular disease
How is hypertension treated?
Weight reduction
Exercise
Decrease salt intake
Alcohol reduction
List 3 measures that will reduce cardiovascular risk but not BP
Smoking cessation
Reduce saturated fat
Increase intake of oily fish
What is a stroke?
Neurological deficit of a presumed vascular cause
What is transient Ischaemic attack (TIA)?
Neurological deficit of presumed vascular cause, last around 24 hours, patient makes full recovery
What suggest a stroke
a) rapid onset of symptoms
b) same symptoms over weeks/months
a
What 2 things can cause stroke?
Ischaemia to brain
Haemorrhage in brain
What type of stroke will thrombosis cause?
Ischaemic stroke
Symptoms of stroke (6)
Paralysis (opposite side of body to brain)
Loss of sensation
Double vision
Unsteadiness
Loss of speech
Loss of ability to use/understand language
What determines which part of the brain is affected by stroke?
Arterial territory effected
Biggest risk factor for stroke?
Hypertension
List 5 other risk factors for stroke, other than hypertension?
Vascular disease Smoking Diabetes TIA Atrial fibrillation
Why is diagnosing and treating high BP important?
Reduce risk of stroke
How is stroke prevented?
Lower BP Surgery - for patient with narrowed carotid artery Aspirin and other anti-platelet drugs Lower cholesterol Warfarin
