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Flashcards in Hypertension Deck (30)
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1
Q

WHO defines hypertension as a blood pressure greater than 120/80. True/False?

A

False

Hypertension is classically BP greater than 140/90

2
Q

How does eating salt increase blood pressure?

A

Increases release of aldosterone, which causes salt and fluid retention [part of RAAS]

3
Q

What are some common causes of secondary hypertension?

A

Renal disease/stenosis
Endocrine disease
Drug therapy

4
Q

How can renal disease lead to hypertension?

A

Reduced renal flow causes excess renin release, ultimately leading to fluid overload

5
Q

Conn’s syndrome is an endocrine cause of hypertension - what happens?

A

Excess production of aldosterone, leading to fluid overload

6
Q

What is Cushing’s syndrome?

A

Excess production of corticosteroid, usually cortisol

7
Q

What are the clinicopathological classifications of hypertension?

A

Benign

Malignant

8
Q

What is meant by benign hypertension?

A

Generally “asymptomatic” but this does not take away from the danger it poses and should be treated as aggressively as normal

9
Q

Every __ mm Hg above diastolic pressure of 85 mm Hg doubles the risk of an MI

A

10 mm Hg

10
Q

What blood vessel changes occur in hypertension?

A

Thickening of media (smooth muscle) layer

Arteriosclerosis (hardened arteries)

11
Q

Define malignant hypertension

A

Life-threatening condition where diastolic pressure greater than 130

12
Q

CVD mortality doubles with every __/__ mm Hg blood pressure increase

A

20/10 mm Hg

13
Q

Automated BP-measuring devices can still measure BP accurately even if the pulse is irregular. True/False?

A

False

Measure BP manually if pulse is irregular

14
Q

When considering a diagnosis of hypertension, does BP need to be measured in both arms?

A

Yes

15
Q

If clinic BP is measured at 140/90, what are the next steps?

A

Measure again: if different, measure 3rd time and use lowest reading as clinic BP
Then offer ABPM/HBPM to confirm diagnosis

16
Q

When using ABPM to confirm hypertension diagnosis, what must be ensured?

A

At least 2 measurements are take per hour during 14 hours;

Use average of these hours to diagnose hypertension (or not)

17
Q

When using HBPM to confirm hypertension diagnosis, what must be ensured?

A

Take 2 consecutive measurements while seated, 1 min apart;
Record twice daily for 4-7 days;
Discard 1st day measurements, use average of rest to diagnose hypertension (or not)

18
Q

Define Stage 1 hypertension

A

Clinic BP = 140/90

+ ABPM/HBPM = 135/90

19
Q

Define Stage 2 hypertension

A

Clinic BP = 160/100

+ ABPM/HBPM = 150/95

20
Q

Define Stage 3 (severe) hypertension

A

Clinic systolic BP = 180
OR
Clinic diastolic BP = 110

21
Q

For all hypertensive patients, which tests would you offer to better assess CVD risk?

A
Test urine (for protein)
Take bloods (glucose, electrolytes, creatinine)
Examine fundi (retinopathy)
Do an ECG
22
Q

What is hypertensive retinopathy?

A

Narrowing of retinal arterioles, increasing the risk of haemorrhage, hard exudates and papilloedema

23
Q

For patients under 80, what is the target BP in response to drug treatment?

A

Less than 140/90

24
Q

For patients over 80, what is the target BP in response to drug treatment?

A

Less than 150/90

25
Q

What is the drug treatment algorithm for hypertension?

A

A/C
A+C
A+C+D
A+C+D+B

26
Q

Which drug would you prescribe to a 54 year old with hypertension?

A

ACEi

27
Q

Which drug would you prescribe to a black guy with hypertension?

A

Ca++ blocker

28
Q

Which drug would you add onto a black guy already on an ACEi and Ca++ blocker whose hypertension is still not controlled?

A

Thiazide diuretic

29
Q

Treating hypertension is cheaper than doing nothing. True/False?

A

True, apparently

30
Q

Give some examples where “resistant hypertension” may occur

A

Non-concordance
White coat hypertension
Poor lifestyle
Secondary hypertension