Lecture 9 - Hypertension and Anti-hypertensives Drugs 1

Question 1

What is high BP a risk factor for?

Answer 1

CHD
Stroke

Question 2

If high BP is left untreated what can it lead to?

Answer 2

Endothelial cell damage => atherosclerosis
Internal organ damage (kidneys, eyes, nerves)
Extra strain on the heart - left ventricular hypertrophy- pulmonary oedema and congestive HF - peripheral oedema

Question 3

Name the types of hypertension

Answer 3

Essential (primary) hypertension - 90-95% no apparent cause
Secondary hypertension - endocrine gland disorders, hyperaldosteronism, pheochromocytoma, Kidney diseases and drugs
‘White coat’ hypertension - increased BP at the doctors

Question 4

Define stage 1 hypertension BP in clinic and mean ABPM/HBPM

Answer 4

140/90 to 179/119 mmHg- clinic BP
135/85 to 149/94 mmHg - mean ABPM/HBPM

Question 5

Define stage 2 hypertension BP in clinic and mean ABPM/HBPM

Answer 5

more than 180/120 mmHg - clinic BP
more than 150/95 mmHg - mean ABPM/HBPM

Question 6

What is the treatment for clinic BP < 140/90 mmHg and ABPM/HBPM < 135/85 mmHg?

Answer 6

Lifestyle changes
BP monitoring at regular intervals (5 years or less)

Question 7

What is the treatment for stage 1 hypertension?

Answer 7

Lifestyle changes
Consider treatment if any of the following:
- age > 80
- target organ damage
- established CVD
- renal disease
- diabetes
- 10 year CV risk equivalent to more than 10%
- age <60 with a 10 year CVD risk <10%
- age < 40 - refer to specialist for secondary causes assessment

Question 8

What is the treatment for stage 2 hypertension?

Answer 8

Initiate treatment
Lifestyle changes

Question 9

What is the therapeutic strategy in treatment of systemic hypertension?

Answer 9

Reduce TPR (decreased after load)
Reduce SV (decrease volume and decrease preload)
Reduce HR

Question 10

What are the system targets in treatment of systemic hypertension?

Answer 10

Sympathetic NS and centrally acting
Kidney
RAAS - renin-angiotensin system
Blood vessels