Hypertension

Question 1

Primary HTN vs Secondary HTN

Answer 1

Primary HTN - No identifiable cause
Secondary HTN - Has an underlying cause

Question 2

What are some causes of secondary HTN

Answer 2

CKD
Diabetic nephropathy
Renal artery stenosis
Cushings
Coarctation of the aorta etc

Question 3

Stage 1 HTN

Answer 3

Clinic: 140/90 mmHg to 159/99 mmHg
ABPM or HPBM: 135/85 - 149/94

Question 4

Stage 2 HTN

Answer 4

Clinic: 160/100 mmHg - 180/120 mmHg
ABPM or HBPM: 150/95 mmHg or higher

Question 5

Stage 3 HTN

Answer 5

Clinic systolic of 180 mmHg or higher or
Clinic diastolic of 120 mmHg or higher

Question 6

What tests can you do to look for target organ damage?

Answer 6

Haematuria.
Arrange measurement of:
Urine albumin:creatinine ratio
HbA1C
Electrolytes, creatinine, and eGFR (to test for chronic kidney disease).
Examine the fundi (for the presence of hypertensive retinopathy).

Question 7

Management of Stage 1 HTN

Answer 7

Discuss starting medications with those:
Age <80 years with persistent stage 1 hypertension who have one or more of the following:
Target organ damage
Established CVD
Renal disease
Diabetes
QRISK of 10% or more.

Question 8

Management of Stage 2 HTN

Answer 8

Offer medications +lifestyle

Question 9

Step 1 of treatment of HTN

Answer 9

Offer ACEi/ARB to:
<55 who are not black African or African-Caribbean family origin
Have type 2 diabetes

Offer CCB to:
>55yrs and do not have T2 diabetes
Black African or African-Caribbean family origin
If CCB is not tolerated offer thiazide-like diuretic e.g. indapamide