pharmaceutical care in hypertension

Question 1

measuring blood pressure

Answer 1

• measure in both arms (use arm with highest BP thereafter)
• take the mean of at least 2 readings
• unless exceptionally high hypertension should be confirmed by repeat measurements over several weeks

Question 2

clinical blood pressure measurements

Answer 2

• BP < 140/90 mmHg monitor every 1-5 years
• BP > 140/90 mmHg treat if high risk (target organ damage, existing CVD, diabetes, 10 year CVD risk >20%)

Question 3

target blood pressure

Answer 3

• most patients a target of <140/<90 mmHg is recommended
• target <130/<80 mmHg if diabetic with complications, existing CVD

Question 4

grade 1 hypertension

Answer 4

systolic: 140/159
diastolic: 90-99

Question 5

grade 2 hypertension

Answer 5

systolic: 160/179
diastolic: 100-109

Question 6

grade 3 hypertension

Answer 6

systolic: >180
diastolic: >110

Question 7

A(B)/C(D) rule

Answer 7

based on renin status
- white and <55 years due to high renin ; ACE/ARB is given
- ethnic and/or >55 years due to low renin ; CCB or diuretic is given
- combine if necessary
- thereafter add alpha-blocker or spironolactone or beta-blocker