L.21 Hypertension

Question 1

Why does blood pressure increase as you get older

Answer 1

• The kidney function decreases so compensate by increasing the blood pressure
• The salt intake over years hardens the artery.

Question 2

What are the causes of hypertension

Answer 2

95% lifestyle or aging: essential hypertension
- Secondary hypertension: kidney disease, adrenal glands: adrenaline, cortisone, aldosterone.
And Co-arctation of the aorta (remnant of the ductus arteriosis blocking the aorta so high blood pressure in their arms but not in the legs. Have to check the femoral-radial delay).this will show up on xray.

Question 3

Who do you treat for hypertension

Answer 3

• BP> 170/100 , but generally 140/90
• If the 5 year risk >15% of CVD
• In primary care its about negotiation: Better to level blood pressure to lower levels, less serious falls but more light headed.

Question 4

What is the treatment for hypertension

Answer 4

• Reducing lifestyle risks such as weight, smoking, exercise, alcohol.
• Drug therapy : ACE inhibitors, diuretic and calcium channel blockers. Then spironolactone, B blockers, a blockers,
  At a pop health level it is reducing salt intake/ alcohol.