Hypertension (CV) Flashcards
What is hypertension defined as?
Persistently high blood pressure (BP)
Hypertension is a condition that requires ongoing management and can lead to serious health complications if untreated.
What are the classifications of hypertension?
- Normal: <120/80 mmHg
- Elevated: 120-129/<80 mmHg
- Stage 1: 130-139/80-89 mmHg
- Stage 2: ≥140/90 mmHg
- Hypertensive crisis: >180/120 mmHg
Each stage of hypertension has specific management strategies.
List the modifiable risk factors for hypertension.
- Obesity
- High salt intake
- Excessive alcohol consumption
- Smoking
- Physical inactivity
- Stress
Addressing these factors can significantly reduce the risk of developing hypertension.
List the non-modifiable risk factors for hypertension.
- Age
- Family history
- Ethnicity (higher prevalence in Black African and Caribbean populations)
These factors cannot be changed but are important for assessing risk.
What are common symptoms of hypertension?
- Often asymptomatic
- Headaches
- Dizziness
- Nosebleeds
- Visual disturbances
- Palpitations
Many individuals with hypertension may not experience symptoms until complications arise.
What are potential complications of untreated hypertension?
- Stroke
- Myocardial infarction
- Heart failure
- Chronic kidney disease
- Hypertensive retinopathy
Complications can lead to significant morbidity and mortality.
What is the gold standard for diagnosing hypertension?
Ambulatory Blood Pressure Monitoring (ABPM)
ABPM measures BP over 24 hours and provides a more accurate picture of blood pressure patterns.
What is the first-line treatment for hypertension in patients under 55?
- ACE inhibitors (e.g., ramipril)
- ARBs (e.g., losartan)
These medications help relax blood vessels and lower blood pressure.
What is the first-line treatment for hypertension in patients over 55 or of Black African/Caribbean origin?
Calcium channel blockers (e.g., amlodipine)
This helps to manage blood pressure effectively in these populations.
True or False: ACE inhibitors and ARBs are recommended for patients over 55.
False
CCBs are recommended for patients over 55, while ACE inhibitors and ARBs are for those under 55.
What role does patient adherence play in hypertension management?
Patient adherence and shared decision-making
These factors are crucial for effective long-term management of hypertension.
What is a second-line treatment for hypertension?
Combination of ACE inhibitor/ARB with a CCB or thiazide-like diuretic
What should be considered for resistant hypertension?
Adding a fourth-line agent (e.g., spironolactone if potassium <4.5mmol/L)
What is the mechanism of action (MoA) of ACE inhibitors?
Inhibits ACE, preventing conversion of angiotensin I to angiotensin II, reducing vasoconstriction and aldosterone secretion
What are common side effects of ACE inhibitors?
- Dry cough
- Hypotension
- Hyperkalemia
- Angioedema
What is the primary function of ARBs?
Blocks angiotensin II receptors, preventing vasoconstriction and aldosterone secretion
What are potential side effects of ARBs?
- Similar to ACE inhibitors but no cough
What is the mechanism of action of calcium channel blockers?
Blocks calcium entry into vascular smooth muscle, reducing contractility and promoting vasodilation
What are common side effects of thiazide-like diuretics?
- Hypokalemia
- Hyponatremia
- Hyperuricemia
- Dehydration
What is the mechanism of action of beta-blockers?
Blocks beta-adrenergic receptors, reducing heart rate and cardiac output
What are the side effects of beta-blockers?
- Fatigue
- Bradycardia
- Dizziness
- Erectile dysfunction
What should be monitored when using ACE inhibitors?
Renal function and potassium levels before and after initiation
What lifestyle modifications are recommended for hypertension management?
- Sodium reduction: Aim for <2.4g/day
- Weight loss: Target BMI <25 kg/m²
- Physical activity: At least 150 minutes of moderate-intensity exercise per week
- Alcohol moderation: <14 units per week
- Smoking cessation and stress management
What recent guidance does NICE NG136 (2023) emphasize for hypertension management?
- Home blood pressure monitoring (HBPM)
- Ambulatory blood pressure monitoring (ABPM)
- Lifestyle interventions alongside pharmacological treatment
Fill in the blank: The recommended target BP for most patients using HBPM or ABPM is _______.
<135/85 mmHg
