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Jamie Cardiovascular Pathology > Hypertension > Flashcards

Hypertension Flashcards

1
Q

What is the definition of hypertension?

A

The blood pressure at which the benefits of treatment outweigh the risks

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2
Q

What BP is Stage 1 hypertension in a clinical setting?

A

140/90 mmHg

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3
Q

What BP is Stage 2 hypertension in a clinical setting?

A

160/100 mmHg

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4
Q

What BP is severe hypertension in a clinical setting?

A

180/110 mmHg

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5
Q

What gender is at a higher risk of getting hypertension?

A

Maleds

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6
Q

What are 5 medical risk factors for Hypertension?

A 
Diabetes
Renal disease
Previous MI or stroke
Hyperlipidaemia 
Left ventricular hypertrophy
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7
Q

How is blood pressure affected by age

A

BP rises with age

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8
Q

What effect does reducing salt intake have on hypertensive individuals?

A

It lowers blood pressure

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9
Q

What effect do small amounts of alcohol have on BP?

A

Decreases BP

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10
Q

What effect do large amounts of alcohol have on BP?

A

Increases BP

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11
Q

What is the most important non-pharmacological measure that can be taken for treating hypertension?

A

Weight reduction

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12
Q

What is the relationship between birth weight and hypertension?

A

The lower the birth weight, the higher risk for developing hypertension later in life

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13
Q

What is the racial influence on blood pressure?

A

Caucasians have lower BP than black population

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14
Q

What is the relationship between black populations and salt intake?

A

Black people are higher salt retainers

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15
Q

What are the effects of sustained hypertension?

A

End-organ damage (blood vessels, heart and kidney)

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16
Q

What are 3 organ-related areas of disease that can be a cause for secondary hypertension?

A

Renal
Endocrine
Vascular

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17
Q

What are 3 types of drugs that can induce hypertension?

A

NSAIDs
Oral contraceptive
Corticosteroids

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18
Q

What condition in pregnancy can cause hypertension?

A

Pre-eclampsia

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19
Q

What night time respiratory condition can be a cause for hypertension?

A

Sleep Apnoea

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20
Q

What are 2 of the main endocrine conditions that can cause hypertension?

A

Conn’s syndrome

Cushings disease

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21
Q

What blood pressure apparatus must be used to identify hypertension in the clinic?

A

ABPM (Ambulatory blood pressure monitoring)

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22
Q

What blood pressure apparatus must be used to identify hypertension at home?

A

HBPM (Home blood pressure monitoring)

23
Q

What 2 actions should be taken in clinic when hypertension is identified?

A

Assess end organ damage

Screen for treatable causes

24
Q

What is the stepped approach?

A

To use low doses of medication and add on to the current medication as opposed to changing it

25
Q

What are the 4 main categories of drug treatments for hypertensive patients?

A

AVE inhibitor
ARB
Calcium channel blocker
Thiazide - type diuretic

26
Q

When should under 80 Stage 1 hypertensives be offered treatment?

A

When there is an additional problem/risk factor (i.e. organ damage/diabetes)

27
Q

What drug should be used as step 1 in over 55s and black people?

A

CCB

28
Q

What drug should be used as step 1 in under 55s? (2)

A

ACE indibitor

ARB

29
Q

What drug should be used as a step 2 in all occasions?

A

Thiazide-type diuretic

30
Q

What is Step 3 treatment of hypertension?

A

CCB, ACEI and diuretic

31
Q

What is step 4 treatment if the blood potassium level is 4.5mmol/l or lower?

A

Further diuretic with low-dose spironolactone

32
Q

What is step 4 treatment if the blood potassium level is higher than 4.5mmol/l?

A

High does thazide diuretic treatment

33
Q

What is the the function of ACE inhibitors?

A

Competitively inhibits angiotensin converting enzyme (ACE)

34
Q

What is the function of ACE?

A

Converts angiotensin I to angiotensin II

35
Q

What are 2 examples of ACE inhibitors?

A

Ramipril

Perindopril

36
Q

What are 2 contraindications of ACEI?

A

Renal failure

Renal artery stenosis

37
Q

What are 3 adverse drug effects of ACEI?

A

Cough
Taste disturbance
Renal impairment

38
Q

What is the function of ARBs?

A

Angiotensin II antagonists that competitively block the actions of angiotensin II

39
Q

What are 2 examples of ARBs

A

Losartan

Valsartan

40
Q

What is a medical benefit of ARBs over ACEI?

A

ARBs don’t produce a cough

41
Q

What are the 2 types of CCB?

A

Vasodilator

Rate limiting

42
Q

What are 2 examples of vasodilator CCBs?

A

Amlodipine

Felodipine

43
Q

What are 2 examples of rate limiting CCBs?

A

Verapamil

Diltiazem

44
Q

How to CCBs work?

A

They block L-type calcium channels which reduces cardiac output

45
Q

In what demographics should vasodilating CCBs be used? (2)

A

Over 55s

Women of child bearing age

46
Q

What are the contraindications for CCBs (1) and those specific to rate limiting CCBs? (2)

A

Acute MI

Heart failure, bradycardia

47
Q

What are 4 adverse drug reactions reactions of CCBs?

A

Flushing
Headache
Angle oedema
Indigestion

48
Q

What are 2 adverse drug reactions specific to rate limiting CCBs?

A

Bradycardia

Constipation

49
Q

What are 2 examples of thiazide-type diuretics?

A

Indapamide

Clortalidone

50
Q

How do thiazide-type diuretics work?

A

They block reabsorption of sodium and enhave urinary sodium loss

51
Q

What are 2 adverse drug reactions of thiazide-type diuretics?

A

Gout

Impotence

52
Q

What hypertension drugs should be used during pregnancy? (2)

A

Thiazide-type diuretics

amlodipine

53
Q

What is accelerated hypertension?

A

A resent significant increase in BP that is associated with target organ damage

Jamie Cardiovascular Pathology (17 decks)

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