Hypertension Flashcards
(27 cards)
What BP value is defined as hypertension?
140/90 clinic or 135/85 ambulatory
What percentage of hypertension is primary?
95%
What are the causes of secondary hypertension? (ROPE)
- Renal disease
- Obesity
- Pregnancy
- Endocrine, most endocrine conditions cause hypertension
What test can be used to check if hypertension is caused by hyperaldosteronism?
renin:aldosterone ratio (blood test)
What are the common complications of hypertension?
- ischaemic heart disease
- Cerebrovascular accident
- hypertensive retinopathy
- hypertensive nephropathy
- heart failure
What is white coat syndrome?
higher than normal BP reading when in a doctors office due to stress of being there can increase by more than 20/10 mmHg
How often should someone without hypertensions BP be checked?
every 5 years
of at higher risk more often
If someone has a clinic blood pressure of above 140/90 mmHg what should be the next step in diagnosis?
24 hour ambulatory BP or home reading
What are the stages of hypertension?
stage 1 - 140/90 (clinic) 135/85 (a)
stage 2 - 160/100 (clinic) 150/95 (a)
stage 3 - 180/120 (clinic)
What further tests should be done when a patient has confirmed hypertension to check for organ damage?
- Urine albumin: creatine ratio and dipstick (kidney damage)
- Bloods: HbA1c, renal function and lipids
- Fundus examination (hypertensive retinopathy)
- ECG (cardiac abnormalities)
What medications are used for hypertension?
- ACE inhibitors
- Beta blockers
- Calcium channel blockers
- Thiazide like diuretics
- ARBs
Give an example of an ACE inhibitor?
ramipril
Give an example of a Beta blocker?
Bisoprolol
Give an example of a calcium channel blocker?
Amlodipine
Give an example of a thiazide like diuretic?
Indapamide
Give an example of an ARB?
Candesartan
When are ARBs used instead of ACE inhibitors?
- if ACE inhibitors not tolerated due to dry cough for example
- black African or African-Caribbean patients
What lifestyle advice should be offered to patients diagnosed with hypertension?
- healthy diet
- stop smoking
- reduce alcohol
- reduce caffeine
- reduce salt intake
- take regular exercise
Who should be offered treatment for their hypertension?
- Anyone with stage 2
- Stage 2 and under 80 and Qrisk above 10% or who has diabetes, renal disease, CV disease or organ damage
What are the first, second, third and fourth line treatments for non-black patients under 55?
1) ACE inhibitors
2) ACE inhibitors + CCB or ACE + Diuretics or CCB + Diuretics
3) ACE + CCB + Diuretics
4) ACE + CCB + Diuretics + either potassium sparing diuretic, alpha blocker or beta blocker
What are the first, second, third and fourth line treatments for black patients or anyone over 55?
1) CCB
2) CCB + ARB
3) ARB + CCB + Diuretic
4) ARB + CCB + Diuretic + either potassium sparing diuretic, alpha blocker or beta blocker
How should the additional medication given in fourth line treatment be chosen?
Serum potassium below 4.5 mmol/l give potassium sparing diuretic if above then alpha or beta blocker
Give an example of an alpha blocker?
Doxazosin
Give an example of a beta blocker?
Atenolol
