L76- Epidemiology & aetiology of hypertension (HYP1 HYP2) Flashcards
what is hypertension?
condition where bp is elevated to an extent where clinical benefit is obtained by lowering it
what are some of the consequences of hypertension?
- Myocardial infarction
- Cerebral vascular
- heart failure
- renal (kidney) disease
who are the high risk patients who are most likely to have complications?
- evidence of cardiovascular disease
- elderly
- diabetes
- renal failure
- lifestyle factors (smokers diet, stress)
what does epidemiology?
the study of how often diseases occur in different groups of people and why
who does hypertension affect the most?
- 65% 65-74yrs
- ethnicity: black African + black Caribbean’s higher incidence
what does aetiology mean?
what is the cause
what are the two types of hypertension?
- primary/essential 90-95%
- secondary 5-10%
what is primary hypertension?
-cause is unknown
what is secondary hypertension?
-there’s an underlying cause
what are some risk factors for primary hypertension?
-increased age
-gender
-obesity
excess alcohol intake
-lack of exercise
-diet
-lifestyle
what is the underlying cause of secondary hypertension?
- renal disease (80%)
- endocrine disease e.g – Cushing’s syndrome Phaeochromocytoma
- pregnancy
- drugs
what drugs might cause hypertension?
• Combined Oral Contraceptives • NSAIDs e.g. ibuprofen • Steroids e.g. prednisolone • Sympathomimetic amines e.g.pseudoephedrine (cold remedies)
what are the properties of a malignant hypertension?
It is uncommon, increases bp
what are the symptoms of a malignant hypertension?
- Confusion, headache, visual loss, coma
- small vessel damage e.g. in the eyes, kidney, brain
what equipment do you use to measure bp?
– auscultatory detection of Korotkoff sounds with stethoscope (manual)
– oscillometrically (automatic)
what is the ‘white coat’ window during bp?
bp increases due to fear and anxiety, physical activity, caffeine, tobacco.
which type of patients will be given an automated sphygmomanmetry?
- white coat HT
- borderline HT
- elderly patients
- pregnant patients
- hypotension
how many hypertension groups are there and the thresholds for treatment?
4 ->180/110 (severe hypertension) - Admit & treat >160/100 (stage 2 hypertension) - Treat >140/90 (stage 1 hypertension) – Offer ambulatory (or home) bp monitoring – (or reassess over 3-4 weeks) – Assess CV risk & end-organ damage – Lifestyle interventions – Treat if target organ damage, established CVD, renal disease, DM or assessed CV risk >10% <140/90 – Reassess every 5 years
