CVD - Risks and Management Flashcards
(28 cards)
What is the optimal blood pressure measurement?
(below) 120/80
What is a normal blood pressure measurement?
(below) 130/85
What are some causes of secondary hypertension? (7)
alcohol, obesity, pregnancy (pre-eclampsia), renal disease eg. parenchymal renal disease, endocrine disease eg. pheochromocytoma, drugs eg. oral contraceptives, coarctation of the aorta
What are some environmental factors that contribute to hypertension?
High salt intake, heavy alcohol consumption, obesity, lack of exercise, impaired intrauterine growth
What are the objectives of an initial evaluation of a patient with high bp readings?
- obtain accurate, representative bp measurements
- identity contributing factors and any underlying causes (eg. secondary causes
- assess other risk factors and quality CVD risk
- detect any complications (target organ damage) that are already present
- identify co-morbidity that may influence choice of anti-hypertensives
What should be done if the first recording of bp is high?
repeat after 5 minutes
How do you avoid incorrectly high bp readings in obese patients?
ensure the cuff contains a bladder that is at least 2/3 of the circumference of the patient’s arm
What is ‘white coat’ hypertension? (and what can be done to avoid it)
abnormally high bp readings when patient gets bp taken at doctors (avoid by asking patient to take bp on a machine at home (ambulatory bp)
How often is a blood pressure check advisable in adults?
every 5 years
What is ambulatory bp monitoring? (and when is it indicated)
automated bp measurements every 20-30 minutes over 24 hours - if there is a high bp reading when taken at the doctors (they wear the cuff for 24 hours)
Why must treatment thresholds and targets be adjusted down when using ambulatory bp as a measurement?
because ambulatory bp is systemically lower than clinic measurements
What is home bp monitoring?
when a patient uses a device at home to record their bp at specific times and notes it down
What is the range for grade 1 hypertension?
140-159/90-99
What is the range for grade 2 hypertension?
160-179/100-109
What is the range for grade 3 hypertension?
over 180/over 110
What is secondary hypertension?
hypertension due to the consequence of a specific disease
How much lower are ambulatory readings compared to clinic measurements?
approx 12/7mmHg
Which ambulatory measurement should be used to guide management decisions?
average ambulatory daytime measurement
What does a radio-femoral delay indicate?
coarctation of the aorta
What could enlarged kidneys indicate?
polycystic kidney disease
What could abdominal bruits indicate?
renal artery stenosis
What does an apical heave usually indicate?
L ventricular hypertrophy
Which target organs can hypertension damage?
blood vessels, CNS, retina, heart, kidneys
How does hypertension damage larger arteries?
The internal elastic lamina is thickened, smooth muscle is hypertrophied and fibrous tissue is deposited. The vessels dilate and become more tortuous and their walls become less compliant
