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Hypertension Flashcards

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1
Q

Chronic elevation in BP (systolic ≥140 mmHg or diastolic ≥90 mmHg)

A

Hypertension

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2
Q

systolic ≥140 mmHg

A

Hypertension

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3
Q

In HT systolic is …..

A

≥140 mmHg

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4
Q

In HT diastolic is …..

A

≥90 mmHg

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5
Q

diastolic ≥90 mmHg

A

Hypertension

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6
Q

more common in some ethnic groups, particularlyAfrican Americans and Japanese

A

Hypertension

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7
Q

Systolic BP < 120

A

Optimal

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8
Q

Systolic BP < 130

A

Normal

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9
Q

Systolic BP 130 - 139

A

High normal

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10
Q

Systolic BP 140 - 159

A

Grade 1 (mild) HT

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11
Q

Systolic BP 160 - 179

A

Grade 2 (moderate) HT

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12
Q

Systolic BP ≥ 180

A

Grade 3 (severe) HT

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13
Q

diastolic BP < 80

A

Optimal

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14
Q

diastolic BP = 85

A

Normal

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15
Q

diastolic BP 85 - 89

A

High normal

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16
Q

diastolic BP 90 - 99

A

Grade 1 (mild) HT

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17
Q

diastolic BP 100 - 109

A

Grade 2 (moderate) HT

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18
Q

diastolic BP > 110

A

Grade 3 (severe) HT

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19
Q

systolic 140 - 159 mmHg and diastolic < 90 mmHg

A

Isolated systolic HT grade 1

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20
Q

systolic ≥ 160 mmHg and diastolic < 90 mmHg

A

Isolated systolic HT grade 2

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21
Q

HT types (4)

A

White-coat hypertension

Primary or essential hypertension

Secondary hypertension

Malignant or accelerated phase hypertension

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22
Q

elevated BP when measured at a health care provider’s office , but normal ABPM (day average <135/85)

A

White-coat hypertension

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23
Q

more likely to develop hypertension in future, and may have the risk of CVD

A

White-coat hypertension

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24
Q

ABPM

A

Ambulatory BP monitoring - 24hr

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25
more than 95% of cases of HT
Essential hypertension
26
no specific underlying cause can be found for HT
Essential hypertension
27
patients who develop hypertension at an early age with or without a positive family history.
Secondary hypertension
28
patients who first exhibit hypertension when over age 50 years
Secondary hypertension
29
patients previously well-controlled now become refractory to treatment.
Secondary hypertension
30
Approximately 5% of patients with hypertension
Secondary hypertension
31
hypertension have specific causes
Secondary hypertension
32
Alcohol
Cause of 2ry HT
33
Obesity
Cause of 2ry HT
34
Renal disease
Cause of 2ry HT
35
Endocrine disease (slides)
Cause of 2ry HT
36
Drugs
Cause of 2ry HT
37
Coarctation of aorta
Cause of 2ry HT
38
rapid rise in BP leading to vascular damage
Malignant or accelerated phase hypertension
39
pathological hallmark is fibrinoid necrosis
Malignant or accelerated phase hypertension
40
Usually there is severe hypertension (eg systolic >200, diastolic>130mmHg) + bilateral retinal haemorrhages and exudates
Malignant or accelerated phase hypertension
41
Papilloedema may or may not be present
Malignant or accelerated phase hypertension
42
may precipitate acute kidney injury, heart failure, or encephalopathy
Malignant or accelerated phase hypertension
43
It is more common in younger and in black subjects
Malignant or accelerated phase hypertension
44
Due to old age:↓Elasticity and ↓compliance of the large blood vessels resulting in ↑ SYSTOLIC BP
Isolated Systolic Hypertension
45
60% of hypertensives > 80 years old
Isolated Systolic Hypertension
46
Usually asymptomatic (except in malignant)
HT
47
Radiofemoral delay, or weak femoral pulses (coarctation) Renal bruits, palpable kidneys Cushing’s syndrome
Signs of renal disease
48
Signs of renal disease
HT
49
Radiofemoral delay,
HT
50
weak femoral pulses (coarctation)
HT
51
Renal bruits
HT
52
palpable kidneys
HT
53
Cushing’s syndrome
HT
54
Retinopathy and proteinuria
HT
55
end-organ damage
HT
56
Renal dysfunction is a factor which may cause ……
HT
57
Peripheral resistance is a factor which may cause ……
HT
58
Vascular tone is a factor which may cause ……
HT
59
Endothelial dysfunction is a factor which may cause ……
HT
60
Autonomic tone is a factor which may cause ……
HT
61
Age
Risk factor of HT
62
High salt intake
Risk factor of HT
63
Obesity
Risk factor of HT
64
Lack of exercise
Risk factor of HT
65
Impaired intrauterine growth and low birth weight
Risk factor of HT
66
All with BP ≥160/100mmHg
Need to be treated
67
BP ≥140/90 with risk of coronary events
Need to be treated
68
BP ≥140/90 with presence of diabetes
Need to be treated
69
BP ≥140/90 with end-organ damage
Need to be treated
70
Management of HT
antihypertensive therapy (Slides)
71
Urinalysis for Blood, protein and glucose
HT investigation
72
Blood urea, electrolytes and creatinine
HT investigation
73
Blood glucose
HT investigation
74
Serum total and HDL cholesterol
HT investigation
75
Thyroid function tests
HT investigation
76
12-lead ECG (L. Ventricular hypertrophy, coronary artery disease)
HT investigation
77
Chest X-ray To detect …. (3)
Cardiomegaly, heart failure, coarctation of aorta
78
Ambulatory BP recording To assess
Borderline/ white-coat HT
79
Echocardiogram To detect or quantify
L ventricular hypertrophy
80
Renal ultrasound To detect …..
Possible renal disease
81
Renal angiography To detect or confirm ……
Presence of renal artery stenosis
82
Urinary catecholamines To detect …
Possible pheochromocytoma
83
Urinary cortisol + dexamethasone suppression test To detect ….
Possible Cushing’s syndrome
84
Plasma renin activity + aldosterone To detect
Possible primary aldosteronism
85
HT treatment goal
<140/90 mmHg
86
HT treatment goal in diabetes
<130/80 mmHg
87
HT treatment goal if aged > 80
150/90 mmHg
88
In HT BP should be reduced slowly why?
rapid reduction can be fatal, especially in the context of an acute stroke
89
Lifestyle changes in HT (5)
Stop smoking Low-fat diet , ↑ vegetables and fruits and low-fat diet Reduce alcohol and salt intake Regular exercise Reduce weight if obese.
90
Diuretics
HT treatment drug
91
Beta Blockers/Alpha-blockers
HT treatment drug
92
Calcium channel blockers
HT treatment drug
93
ACE-i or ARB
HT treatment drug
94
Aldosterone antagonists
HT treatment drug
95
Vasodilators
HT treatment drug

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