Hypertension

Question 1

Hypertension Stages:
Stage 1:
Stage 2:
Severe:

Answer 1

Stage 1 hypertension
Clinic 140/90
ABPM 135/85

Stage 2 hypertension
Clinic: 160/100
ABPM: 150/95

Severe hypertension
Clinic s 180
Diastolic 110

Question 2

Causes of Hypertension:
EH
RD - R-P
ED - CCAP

Answer 2

Causes of Hypertension:
Essential Hypertension: 95% unknown
Renal Disease: Renal Artery Stenosis, Polycystic Kidney Disease
Endocrine Disease: Conn’s Syndrome, Cushing’s Disease, Acromegaly, Phaeochromacytoma

Question 3

Patients with Hypertension should be considered for: 
R
R
R
R
W
P

Answer 3

Patients with Hypertension should be considered for: 
Renal Disease
Renal Bruits
Retinopathy
Radio-femoral delay
Weak femoral pulse
Proteinuria

Question 4

Hypertension is a risk factor for:
1.
2.
& accounts for __% of vascular deaths.

Answer 4

Hypertension is a risk factor for:
1. Stroke
2. Myocardial Infarction
& accounts for 50% of vascular deaths.

Question 5

Hypertension Signs/Symptoms:
A
CP
B
H
P
F
V

Answer 5

Hypertension Signs/Symptoms:
Asymptomatic
Chest Pain
Breathlessness/Dyspnoea 
Headache
Palpitations
Fatigue 
Vision problems

Question 6

Hypertension Investigations:
S
B
E
E
U
RUS
ABPM

Answer 6

Hypertension Investigations:
Sphygomanometer - BP cuff
Bloods: FBC, U & E, Glu, Lipids, Calcium, Phosphate, Antibody
ECG
Echocardiogram
Urine Dipstick - Haematuria & Proteinuria 
RUS - Renal US
ABPM - Ambulatory BP Monitoring

Question 7

Hypertension Treatment: 
Step 1
Step 2
Step 3
Step 4 <
Step 4 >

Answer 7

Hypertension Treatment:

Step 1 - ACEI/ARB if < 55yrs - not for young women (CCB-CBA, BB-preg-Labetol). >55yrs = CCB
(If CCB not suitable (HF) TLD).

Step 2 - Add Thiazide Like Diuretic (Clortalidone/Indapamide) (on top off ACEI/ARB or CCB).

Step 3 - Add Diuretic to ACEI/ARB + CCB

Step 4 - If K = or < 4.5 mmol/L = LD Spironolactone
Step 4 - If K > 4.5 mmol/L = HD TLD or add Alpha/Beta Blocker

Question 8

Hypertensive Pregnant Women:

Answer 8

Beta Blockers: Labetol

Question 9

Hypertensive Women of Child Bearing Age:

Answer 9

Calcium Channel Blockers - not ACEI/ARB

Question 10

Hypertensive Africain/Caribbean Individuals

Answer 10

Thiazide Like Diuretic or Calcium Channel Blockers

Question 11

First Line Treatment: in Diabetics

Exceptions:

Answer 11

First Line Treatment: ACEI - Ramipril

Exceptions: Afro-Caribean, CBW