treatment of hypertension Flashcards
how would you diagnose hypertension?
Must use ABPM Ambulatory Blood pressure Monitoring
or HBPM Home Blood pressure Monitoring
what would be stage 1 hypertension?
Clinic blood pressure is 140/90 mmHg or higher
ABPM daytime average 135/85 mmHg or higher
what would be stage 2 hypertension?
Clinic blood pressure is 160/100 mmHg or higher
ABPM daytime average 150/95 mmHg or higher.
what would be severe hypertension?
Clinic systolic blood pressure is 180 mmHg or higher or diastolic blood pressure is 110 mmHg or higher.
what are the 3 type of treatment for hypertension?
ACE (young)
CCB
thiazide- type diuretic
what is the prevelance of pre-hypertension
3-10%
what is the prevelance of hypertension depending on age and ethnicity?
0.1-3%
what can childhood hypertension lead to?
Adult hypertension
Target organ damage
what is the effect of childhood hypertension on end organ damage?
Left ventricular hypertrophy (LVH)
Decreased vascular responsiveness
Increased carotid artery intimal medial thickness (cIMT)
Reduced GFR
Increased atheroma deposition
Reduced cognitive scores in hypertensive children
whats the commonest cause of hypertension in newborn infants?
Renal artery thrombosis
Renal artery stenosis
Congenital renal malformations
Coarctation
whats the commonest cause of hypertension in infants?
Renal parenchymal disease
Coarctation
Renal artery stenosis
whats the commonest cause of hypertension in 6-10 years?
Renal parenchymal disease
Renal artery stenosis
Primary hypertension
whats the commonest cause of hypertension in 10-18?
Primary hypertension
Renal parenchymal disease
what is accelerated hypertension?
Increase in blood pressure to levels ≥180 mm Hg systolic and ≥110 mm Hg diastolic resulting in target organ damage such as neurological, cardiovascular or renal damage plus grade III retinal changes.
what is malignant hypertensiojn?
The term malignant hypertension is usually reserved for cases where papilloedema grade IV fundal changes are present.
what is accelerated hypertension associated with?
An existing diagnosis of HTN and prescribed antihypertensive agents.
Poor BP control prior to presentation.
A lack of a primary care contact. Lack of healthcare in general
Non Adherence To Medication.
Illicit drug use in both urban and rural communities.
what are the treatment guidelines?
reducing mean arterial pressure by ≤25% for the first hour, and then to 160/100-110 mmHg by 2-6 hours with subsequent gradual normalization over 24-48 hours.
what should you not do when treating hypertension?
Do not reduce BP suddenly and excessively.
Do not use sublingual medication.
Do not use rapidly acting nifedipine or ACEI.
Do not use intermittent as required therapy, oral or IV.
Do not use IV hydralazine
5-20 minute lag before producing an erratic response
Do not use sodium nitroprusside
