HTN Flashcards
in what patient populations is hypertension more common in?
advancing age,
women aged 65-74,
people of African origin
what are the complications of hypertension?
stroke, MI, heart failure, renal failure and dissecting aortic aneurysm
what sounds are you listening for when using a stethoscope to measure bp manually?
korotkoff
how many distinct korotkoff sound phases are there?
5
what produces korotkoff sounds?
blood pressure cuff changes the flow of blood through the artery
what should phase 1 korotkoff sound like?
1st sound heard
sharp tapping as cuff pressure released and provides systolic pressure reading
what should phase 2 korotkoff sound like?
swishing sound as blood flows through vessels as cuff is deflated
what does phase 3 korotkoff sound like?
thump sounds softer than phase 1 as blood flows through artery but cuff pressure inflated to occlude flow inside diastole
what does phase 4 korotkoff sound like?
soft muffled sound as cuff pressure released
what does phase 5 korotkoff sound like?
silence as cuff pressure released enough to allow normal blood flow
the point at which all sounds completely disappear is the X pressure?
diastolic
what is defined as stage 1 hypertension?
clinic reading 140/90 -160/100
stage 1 htn is a ambulatory daytime average of home bp monitoring of?
average 135/85 or higher
what is defined as stage 2 hypertension?
clinic BP 160/100 - 180/120
stage 2 htn is an ambulatory daytime average of home blood pressure average of ?
150/95 or higher
what does htn Tx aim to do?
reduce the risk of cardiovascular morbidity and mortality, by reducing BP
what algorithm is used to calculate an accurate assessment of cv risk as a guide to htn management and level of risk for patient and if and when pharmacological treatment is needed?
QRISK3
what does QRISK3 indicate?
persons risk of developing heart attack or stroke over next 10 years
true or false, QRISK3 prevents average risk of people with same risk factors as those entered for that person?
true
it is important that before adding an additional agent to control htn you ave tried the first agent to the maximal dose. What might prevent you from doing this?
SEs
What is the target clinic blood pressure for a 50 year old male with no other co-morbidities?
below 140/90
Why do blood pressure targets vary?
location
anxiety
stress
px characteristics
Why are ACE or ARBs not first line in people who are African or African-Caribbean family origin?
lower renin levels hence less of a response to drugs that act via RAS
Why is it specifically thiazide-like diuretics that are recommended for HTN and not loop diuretics like furosemide?
thiazide like act on dct where less filtered sodium reabs
loop act on ascending loh where more sodium reabs
more efficient water loss but short half life so not good for consistent sustained bp drop
