BNF Treatment summary Flashcards
(11 cards)
What is hypertension defined as
persistently raised arterial bp
what is hypertension a risk factor for
- stroke, myocardial infarction, HF, CKD, cognitive decline, and premature death
what non drug treatment can be offered for hypertension
- lifestyle changes- regular exercise, healthy diet, low dietary sodium intake, reduced alcohol intake
- discourage excessive consumption of caffeine rich products and encourage smoking cessation
when should patients be offered ambulatory bp monitoring or home bp monitoring
if they have a bp of 140/90 or above
what is stage 1 hypertension
clinic bp ranging from 140/90- 159/99, and an ABP average ranging from 135/85-149/94
when would you consider starting antihypertensives
- in patients aged under 80 who have stage 1 and one or more of the following:
- target organ damage
- established CVD
- renal disease
- diabetes
- 10 year CV risk of >10% - patients over 80 with clinic bp of over 150/90
- SIGN recommends for all pts at high CV risk and sustained bp of 140/90 regardless of age
- pts who have had a haemorrhagic or ischaemic stroke, or TIA, even when their baseline bp is normotensive
what is stage 2 hypertension
clinic bp of >160/100 but less than 180/1200, and an ABP of 150/95 or higher
what is severe hypertension
clinic systolic bp of 180 or higher, or a clinic diastolic bp of 120 or higher
when would you conduct a same day specialist referral
- if they have suspected phaeochromocytoma (labile or postural hypotension, headache, palpitations)
- if they have a clinic bp of 180/120 or higher with signs of retinal haemorrhage or papilloedema, or life threatening symptoms such as new onset confusion, chest pain, signs of HF or AKI
what to do if target organ damage is identified
consider starting antihypertensive immediately, without waiting for results of ABPM or home monitoring
- if no target organ damage identified, repeat clinic bp within 7 days
