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Week 1 - Hypertension > Management of Hypertension > Flashcards

Management of Hypertension Flashcards

1
Q

What is blood pressure?

A

The pressure exerted on arterial walls by the volume of blood ejected from the heart.

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2
Q

What is systolic pressure?

A

The peak pressure in the arteries during heart contraction (the higher value in a blood pressure reading).

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3
Q

What is diastolic pressure?

A

The minimum pressure in the arteries when the heart is relaxed (the lower value in a blood pressure reading).

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4
Q

How is blood pressure calculated?

A

BP = Cardiac Output (CO) × Systemic Vascular Resistance (SVR).

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5
Q

How is blood pressure related to blood flow and resistance?

A

Blood pressure is the product of blood flow and the resistance by the vessels.

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6
Q

How do drugs typically reduce blood pressure?

A

By either reducing cardiac output or decreasing resistance in the blood vessels.

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7
Q

What is hypertension?

A

Hypertension is when the force of the blood pushing against the walls of the arteries is consistently too high.

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8
Q

What damage can hypertension cause?

A

It can damage artery walls, cause fatty deposits, and limit circulation of blood and oxygen.

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9
Q

What is secondary hypertension?

A

High blood pressure caused by identifiable factors like hormone abnormalities, kidney disease, diabetes, or certain medications.

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10
Q

What are common risk factors for hypertension?

A

Drinking too much alcohol, smoking, being overweight, lack of exercise, and too much salt in the diet.

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11
Q

What is primary hypertension?

A

Also known as essential hypertension, it accounts for 95% of cases and has no identifiable cause.

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12
Q

What are the most dangerous effects of hypertension?

A

Heart attack, heart failure, stroke, kidney damage, and plaque buildup in arteries.

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13
Q

Why is it important to treat hypertension?

A

It is a major risk factor for premature morbidity and mortality, linked to stroke, heart attack, heart failure, and kidney disease.

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14
Q

What are the stages of hypertension?

A

Stage 1: Clinic reading 140/90–159/99, home reading 135/85–149/94.
Stage 2: Clinic ≥160/100, home ≥150/95.
Stage 3: Clinic systolic ≥180, diastolic ≥110.

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15
Q

When should ambulatory blood pressure monitoring (ABPM) be used?

A

In cases of suspected “white coat” hypertension, borderline cases, or treatment-resistant hypertension.

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16
Q

What are the usual asymptomatic symptoms of hypertension?

A

Usually asymptomatic.

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17
Q

What examinations do you do when testing for hypertension?

A

Urinalysis – dipstick / albumin:creatine ratio (blood and protein)
12 lead ECG if indicated (left ventricular hypotrophy)
U + E (kidney function, sodium and potassium)
Lipid profile
BM / Hb1AC (ruling out diabetes)
OP ECHO if indicated (function of heart)
Fundoscopy (eyes)
Check hx for neurological symptoms
Check signs of heart failure / heart sounds

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18
Q

Who needs treatment for stage 1 hypertension?

A

Target organ damage
Established / history cardiovascular disease
Renal disease
Diabetes
An estimated 10-year risk of cardiovascular disease of 10% or more

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19
Q

Who needs treatment stage 2 hypertension?

A

Everyone

20
Q

What lifestyle changes can help manage hypertension?

A

Weight management, reducing alcohol consumption to ≤14 units/week, reducing salt intake to 4.4g/day, and regular exercise.

21
Q

What are the main classes of medications used to treat hypertension?

A

ACE inhibitors or ARBs
Calcium channel blockers
Thiazide-type diuretics

22
Q

What happens if someone is resistant to the first line of treatment?

A

B-blocker (second line)
Other alpha blockers, spironolactone

23
Q

How do ACE inhibitors work?

A

They block the conversion of angiotensin I to angiotensin II, reducing blood pressure by dilating blood vessels and decreasing fluid retention.

24
Q

What does angiotensin II do?

A

Causes vessels to block - increasing blood pressure

25
Q

What do ACE inhibitors effect?

A

Heart rate and cardiac output

26
Q

What do ACE inhibitors reduce the release of?

A

Aldosterone which causes fluid and water retention

27
Q

What are examples of ACE inhibitors?

A

Ramipril, enalapril, lisinopril, perindopril

28
Q

What are common side effects of ACE inhibitors?

A

Dizziness, orthostatic hypotension, gastrointestinal stress, cough, and acute kidney disease.

29
Q

Which ethnicity can you not use ACE inhibitors on?

A

Black and Afro-Caribbean

30
Q

Who do you not give ACE inhibitors to?

A

Bilateral or renal artery stenosis
Hyperkaliemia
Hypotension

31
Q

What is a rare side effect of ACE inhibitors?

A

Angioedema

32
Q

When are angiotensin II receptor antagonists (AIIRA) or angiotensin II blockers (ARB) given?

A

When ACE inhibitors don’t work.

33
Q

What is the role of angiotensin II receptor antagonists (AIIRA) or angiotensin II blockers (ARB)?

A

Reduced the action of angiotensin II.

34
Q

What are the properties of angiotensin II receptor antagonists (AIIRA) or angiotensin II blockers (ARB) similar to?

A

ACE inhibitors

35
Q

What are dihydropyridines?

A

Nifedipine, amlopidine, felodipine – predominately affecting vascular smooth muscle – causing vasodilation – side effect: swelling of ankles

35
Q

What are calcium channel blockers, and how do they work?

A

They block calcium from entering cells, causing vasodilation, reduced heart rate, and lower blood pressure.

35
Q

What happens to the tube during vasodilation?

A

Tubes get wider to reduce pressure

36
Q

What are examples of Angiotensin II receptor antagonists (AIIRA) or angiotensin II blockers (ARB)

A

Candesartan, irbesartan, losartan

37
Q

What are the side effects of calcium channel blockers?

A

Ankle swelling, flushing, headaches, dizziness, constipation, and bradycardia.

38
Q

What are the two types of calcium channel blockers?

A

Dihydropryidines
Non-dihydropryidines

39
Q

What are non-dihydropyridines?

A

Verapamil & diltiazem – slows the heart rate affecting myocardial tissue

40
Q

How do thiazide-type diuretics work in hypertension?

A

They reduce blood pressure by decreasing sodium and water retention, lowering blood volume and peripheral resistance.

41
Q

What are common side effects of thiazide diuretics?

A

Dizziness, electrolyte imbalances, and gastrointestinal disturbances.

42
Q

What are rare side effects of thiazide type diuretics?

A

Blood disorders – bone marrow suppression
Impotence

43
Q

What are beta blockers, and when are they used in hypertension?

A

Beta blockers reduce blood pressure by blocking beta receptors, used as a second-line drug or in specific cases like pregnancy or sympathetic overactivity.

44
Q
A

Week 1 - Hypertension (4 decks)

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