Hypertension Flashcards
Describe some complications of HTN
Brain- stroke, haemorrhage Heart- LVH, CHD, CHF, MI Kidney- renal failure, proteinuria Eye- retinopathy Peripheral vascular Disease
Define Stage 1 HTN
Clinical BP= 140/90
ABPM- 135/85
Define Stage 2
Clinical= 160/100 ABPM= 150/95
Define Severe HTN
Either systolic over 180 or diastolic over 110
What percentage of HTN is primary (idiopathic)?
90%
Risk Factors?
Male Smoker Age 55+ Post menopausal Women Obesity Previous MI/ Stroke Diabetes Hyperlipidaemia General Low fitness LV hypertrophy
How does birth weight influence HTN?
Low birth weight increases risk
What is the influence of genes?
May be more common in families- predisposed risk
List the causes of Secondary HTN
Renal Disease- sodium and water retention Drug Induced- NSAIDs, OTC, Steroids Pregnancy- pre-eclampsia Endocrine- Conn's, Cushings Vascular- coarctation of aorta Sleep Apnoea
Name two ways of monitoring Blood Pressure
ABPM- ambulatory BP monitoring
HBPM- Home BP monitoring
How would you assess end organ damage?
ECG & ECHO- heart failure, LVH
Renal Ultrasound- Kidney failure, eGFR
Blood tests- proteinuria, LFT
What treatable causes would you screen for?
Renal Artery Stenosis Fibromuscular Dysplasia Cushings Conn's Syndrome Sleep Apnoea
Why treat HTN?
Reduce risk of Stroke by 40-50%
Reduce incidence of MI- 15-30%
How to treat?
Stepped Approach
Which drugs?
YOUNG U55= ACE Inhibitor/ ARB
Over 55= CCB
Afro Carribean= CCB
Women of child bearing age= CCB
