Tutorial 16 - Hypertension Flashcards

1
Q

What is hypertension?

A

Persistently raised blood pressure.

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2
Q

What is the difference between primary and secondary hypertension?

A
  • Primary - No identifiable cause - most common (90%).
  • Secondary - Known cause - renal/endocrine/vascular cause.
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3
Q

How can hypertension be staged?

A
  • Stage 1 - Rangeing from 140/90 to 159/99
  • Stage 2 - Rangeing from 160/100 to 179/119
  • Stage 3 - Above 180/120
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4
Q

What are the risk factors for hypertension?

A
  • Increasing age
  • Co - existing co-morbidities - diabetes or CKD.
  • Lifestyle choices - smoking, alcohol, high salt diet.
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5
Q

What are the possible complications of hypertension?

A
  • Heart failure (left ventricular hypertrophy and consequent failure).
  • Coronary heart disease and MI
  • CKD
  • Stroke
  • Peripheral arterial disease
  • Vascular dementia
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6
Q

What is 1st line for patient below the age of 55,non afro carribean ethnicity and potentially have type 2 diabetes?

A
  • ACEI -ramipril
  • ARB - Candesartan
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7
Q

What is 1st line for a patient who is over the age of 55 or are black/Caribbean ethnicity?

A
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8
Q

How do ACEI and ARB’S work?

A
  • They both ultimately work to decrease blood pressure by blocking the vasodilative and aldosterone secreting effects of AT2.
  • ACEI - Block ACE
  • ARBS- Block eeffect of AT2 at AT1 receptor.
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9
Q

What are the possible side effects of ACEI/ARB’s?

A
  • Hypotension
  • Hyperkalaemia (muscle weakness,)
  • Cough
  • Angioedema
  • Renal detoriation
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10
Q

Contraindications for prescription of ACEI/ARB’As.

A
  • Angioedema
  • Renal disease i.e., renal artery stenosis.
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11
Q

What is 1st line for a person over 55 and affro carribean ethnicity.

A
  • CCB - amlodipine
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12
Q

How does amlodipine work.

A
  • Relaxes muscles around blood vessels and thereby increases its diameter - decreasing the blood pressure.
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13
Q

What are the possible side effects of amlodipine?

A
  • Peipheral oedema
  • Tachcardyia
  • flushing
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14
Q

What are the contraindications for amlodipine?

A
  • Cardiogenic shock
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15
Q

What is done after these drug treatments?

A
  • Mix and match ACEI with CCB
  • Introduce thiazide like diuretics
  • Introduce alpha blocker (ideal if they also have an enlarged prostate), beta blocker(ideal if they also have anxiety) or spironolactone.
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