L9 - Pharmaceutical Care For Patients With Hypertension

Question 1

What is the definition of hypertension?

Answer 1

A condition where blood pressure is elevated to a level where clinical benefit is achieved from blood pressure lowering.

Question 2

What are the key complications of hypertension?

Answer 2

• Coronary heart disease.
• Stroke.
• Heart failure.
• Renal failure.
• Retinopathy.

Question 3

How is hypertension diagnosed?

Answer 3

• Measure blood pressure in both arms, using the arm with the highest BP for subsequent readings.
• Take the mean of at least two readings.
• Confirm sustained hypertension with repeat measurements or ambulatory blood pressure monitoring (ABPM).

Question 4

What are the targets for blood pressure in hypertension?

Answer 4

• ≤140/90 mmHg for most patients.
• ≤130/80 mmHg for diabetics with complications or existing CVD.

Question 5

What lifestyle changes are recommended for managing hypertension?

Answer 5

• Weight reduction.
• Smoking cessation.
• Regular exercise.
• Salt reduction.
• Healthy diet.
• Alcohol moderation.

Question 6

What is the “ACD” principle for hypertension management?

Answer 6

• A: ACE inhibitors or ARBs.
• C: Calcium channel blockers.
• D: Thiazide-like diuretics.
• Tailored based on renin status:
• A: for white patients <55 years.
• C/D: for Afro-Caribbean patients or those ≥55 years.

Question 7

When are beta blockers used in hypertension?

Answer 7

• Not preferred for initial treatment.
• Used when there are compelling indications (e.g., heart failure).
• Can be considered for white patients <55 years if ACE inhibitors/ARBs are unsuitable.

Question 8

What is pharmaceutical care in hypertension?

Answer 8

The responsible provision of drug therapy to achieve specific outcomes that improve a patient’s quality of life.

Question 9

What is the role of statins in cardiovascular disease prevention?

Answer 9

• Secondary prevention: Atorvastatin 40-80 mg, targeting LDL <2 mmol/L.
• Primary prevention: Atorvastatin 20 mg for patients with a 10-year CVD risk ≥10% or diabetes.

Question 10

What drugs can exacerbate hypertension?

Answer 10

• NSAIDs.
• Oestrogens (e.g., oral contraceptives).
• Sympathomimetics.
• Corticosteroids.
• Medications with high sodium content.

Question 11

What are the key learning points for managing hypertension?

Answer 11

• Understand hypertension classification and BP targets.
• Know pharmacological and non-pharmacological management strategies.
• Apply the ACD principle based on patient characteristics.
• Recognise compelling indications and contraindications for drug groups.
• Monitor key parameters for each drug and emphasise patient counselling.