W24 - Hypertension Flashcards
What are 4 key cardiovascular disease
Hpertension
Ischaemic heart disease
Heart failure
Arrhythmia
what is hypertension
high blood pressure
when clinic blood pressure is > 140/90 mmHg for people ages under 80
Bp up to 150/90 if those over 80
what are the three stages of hypertension
> 140/90 stage 1 hypertension
160/100 stage 2 hypertension
180 or DBP >110 mmHg severe hypertension
why should we even bother with hypertension treatment what can it cause
stroke blindness heart attack heart faillure kidney failure
who should be offered lifestyle advise
offer lifestyle advice in anyone under 80 stage 1 hypertension who has at least one of the following
target organ damage established cardiovascular disease renal disease diabetes high cardiovascular risk under 40 years old
when should we consider treatment
anyone with stage 2 or severe (urgent)
what can be given to treat hypertension
ACE inhibitor (Diabetes)
Angiotensin Receptor Blocker (Diabetes)
Calcium channel blocker
Thiazide like diuretic
Outline treatment plan for hypertension non diabetic
Calcium channel blocker combined with lifestyle advice
calcium channel blocker + Ace inhibitor, Angiotensin Receptor blocker or thiazide like diuretic
Ace inhib + calcium channel blocker + thiazide like diuretic
confirm resistant hypertension, confirm elevated BP
consider seeking expert advicE
ADD low dose pironolactone if blood potassium <4.5
Alpha blocker or beta blocker >4.5
Outline treatment plan for hypertension diabetic
Ace inhibitor or ARB
CCB
Thiazide like duiretic
confirm resistant hypertension, confirm elevated BP
consider seeking expert advicE
ADD low dose pironolactone if blood potassium <4.5
Alpha blocker or beta blocker >4.5
What monitoring should be taken into account for ACE/ARB
urea and creatinine
what monitoring should be looked at for calcium channel blocker
heart rate
ankle oedemea
what monitoring should be looked at for thiazide like diuretics
urea and creatinine
electrolytes
uric acid if at risk of suspect gout
what might drug drug interactions cause
increase or decrease effects of the antihypertensive drug
what might an example of drug disease interaction be
some drugs may increase or reduce BP
what is an example of Co morbidity
pre existing or new condition may increase
what is coronary heart disease
umbrella term covering a range of conditions all caused by atherosclerosis
angina
non st segment myocardial infarction
st segment myocardial infarction
What are cardiac symptoms of CHD
central or band like pressure or pain
sub-sternal pain
radiation to jaw arm or back
fast pulse
may be relieved by GTN/rest
what are respiratory symptoms of CHD
fast respiratory rate
persistant localised pain
pain worsens on breathing deeply or coughing
knife like
what are GI symptoms of CHD
epigastric burning pain
often after food or at night
relieved by antacid
difficulty swallowing
tenderness
what are infection symptoms of CHD
High temperature
Previous viral illness
Fast pulse
infected sputum
what are some mental health symptoms of CHD
stressed
anxious
not radiating
fast pulse
palpitation
fast respiratory rate
relieved by breathing techniques and distractions
what might a patient with MI have
Patients having an MI often look grey in colour, sweaty, feel dizzy, short of breath, feel or be sick, pain may be felt in the back or radiating down the left arm or jaw.
diabetics not always feel the severity of pain but are especially high risk.
what are the locations of pain for myocardial infarction (Heart attack)
left arm radiation
irradiation in the back
What is ACS
acute coronary syndrome ACS is unpredictable and not relieved by GTN and is classed as an emergency
