L13: Hypertension

Question 1

What is hypertension classified into

Answer 1

Primary

Secondary

Question 2

What is primary hypertension

Answer 2

Has no identifable single cause

Question 3

What is secondary hypertension

Answer 3

Has a known underlying cause of hypertension

Question 4

What factors other than BP increase cardiovascular risk

Answer 4

Male sex
Age
Smoking
Dylipidemia
Obesity
Family history
Cholesterol

Question 5

What are the causes that cause secondary hypertension

Answer 5

Renal disease
Vascular disorders
Endocrine disorders
Drugs

Question 6

What is an endocrine disorder that can cause hypertension

Answer 6

Primary hyperaldosteronism

Question 7

How does primayr hyperaldosteronism cause hypertension

Answer 7

High levels of aldosterone act on the kidney to cause sodium retention which causes water retention and volume expansion causing hypertension

Question 8

What is an ambulatory blood pressure monitoring for

Answer 8

If the patient has a raised blood pressure in clinic you can measure their bp for 24 hours, which then the average bp is calculated

Question 9

What are the uses of abpm for

Answer 9

To diagnose hypertension
To diagnose white coat syndrome
Suspected of masked hypertension
Suspectd hypotension
Suspectd pre-eclampsia

Question 10

What is stage1 hypertension defined as

Answer 10

Clinic blood pressure as: greater or equal to 140/90 or 135/85 in ABPM

Question 11

What happens when the systolic and diastolic pressur fall into different catergories

Answer 11

We take the highest pressure to determine the stage

Question 12

What is white coat syndrome

Answer 12

when the patient has a high blood pressure in clinic but a nromal ABPM

Question 13

What is the aim for treating hypertension

Answer 13

Lower the blood pressure to reduce the risk of end organ damage, CVD, clinical events, mortality.

Question 14

What is the the target blood pressure we aim for people under 80years old

Answer 14

Less than 140/90

Question 15

What is the target of blood pressure we aim for people ages 80 years or older

Answer 15

Less than 150/90

Question 16

What is a conervative management of hypertension

Answer 16

Lifestyle advice:

• moderate alcohol
• reduce salt
• stop smoking
• exercise
• weight reduction
• reduce stress

Question 17

To reduce the risk of cvd in patients with hypertension what can we do

Answer 17

prescibe statins- reduce cholsterol
Antiplatelet therapy- for stroke and chronic artery disease
Treat diabetes
Treat heartfailire- beta blockers, RAAS, and sprinolactone

Question 18

Which approach is used to presciribe antihyeprtensive drusg

Answer 18

Step wise approach

Question 19

What are the 2 categories of people in the stepwise apprach

Answer 19

Younger than 55

55 years older or black patients at any age

Question 20

What is the first line management of younger patients of less than 55

Answer 20

Ace inhibitor

Question 21

What is the first line treatmetn for patients older than 55 and blakc

Answer 21

Calcium channle blockers or diuretics

Question 22

What is the second line treatmetn in patients

Answer 22

Ace inhibitor and calcium channel blocker
Or
Ace inhibitor and diuretics

Question 23

What is the third line treatmetn

Answer 23

Ace inhibitor
Calcium channel blocker
Diuretics

Question 24

What is the 4th line treatment

Answer 24

Add:
Diuretics
Alpha blcoker
Beta blocker 
Consider seeking specialiast advice

Question 25

If ace inhibitors are not tolerated what can we use

Answer 25

Arbs

Question 26

If calicum channel blockers are not tolerated whst can we use

Answer 26

Diuretics