Hypertension Flashcards
(22 cards)
What are the two aetiologies of hypertension?
Primary- due to diet etc.
Secondary- due to underlying disease
What are the two outcomes of hypertension
Benign- predisposes to many complication
Malignant- is life threatening and damaging in itself
What kind of hypertension do most people have
primary
What are common causes of secondary hypertension
Renal disease eg renal artery stenosis
Sleep apnoea
What are rarer causes of secondary hypertension
Intracranial disease
Endocrine disorders eg conn’s, cushings, pheochromacytoma
Coartication of the aorta
What is conns syndrome
increase aldosterone
What is cushings syndrome
increased corticosteroid
What is a pheolchromcytoma?
neuroendocrine tumour, increased noradrenaline
What does benign hypertension potentially cause
LV hypertrophy CHF More atheromas AAA, dissection Renal disease Stroke Arrythmia -->sudden cardiac death
What is the definition of malignant hypertension
DBP of more than 130
What be the outcome of malignant hypertension
Can develop from primary or secondary or de novo Cerebral oedema Acute renal or heart failure Cerebral haemorrhage fibrinoid necrosis of blood vessels
What causes isolated systolic hypertension
atherosclerosis
How is a diagnosis of hypertenion made?
if clinical BP is more than 140/9 then ambularory or hime BP monitoring is used to make the diagnosis
How is ABPM done?
Two measurements every hour that the patient is awak
Must be the average of at least seven hours
How is HBPM done?
Two measurements taken one min apart for at least four days but prefereably seven
The first day doesnt count and an average of the remaining days is taken
What is stage 1 hypertension
Clinical BP more than 140/90
Home or ambulatory 135/85 or higher
What is stage 2 hypertension
Clinical 160/100
Home/A is 150/95 or higher
What is stage 3 hypertension
Clinical systolic more than 180 or diastolic more than 110
What should be the initail management of hypertension
offer: urine bloods eye exam 12 lead ecg establish risk with ASSIGN score
How do you decide if pharmacological intervention is needed?
If end organ damage or diabetes
Stage 3 hypertension
What is the aim BP
Less than 140/90 if less than 80
less than 150/90 if over 80
What is the treatment guidlines for hypertension
If over the age of 55 or black = Calcium channel blocker
If under 55 = ACE inhibitor (not in women of child bearing age)
If not adequate- combine
If still not adequate- add thiazide
If not adequate still consider : increase thiazide, spironolactone, beta blocker (consider in younger person or angina)
