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Flashcards in Hypertension Deck (23):
1

What percentage of people with hypertension have essential/idiopathic hypertension?

95%

2

Name 4 factors that would predispose an individual to developing hypertension

Sympathetic stimulation, genetics, activation of RAAS, endothelial dysfunction (less NO released), smoking, drinking, obesity, low birth weight

3

What percentage of the adult population have essential hypertension?

40%

4

Which ethnic group suffer hypertension more commonly?

Black people

5

What sensory organ is often affected by hypertension?

Eyes (hypertensive retinopathy)

6

What is grade 1 hypertensive retinopathy?

Increased vessel tortuosity and silver wiring

7

What is the second stage of hypertensive retinopathy?

Grade 1 with arteriovenous nipping where thickened arteries cross over veins

8

What is grade 3 hypertensive retinopathy?

As grade 2 but with soft cotton wool exudates and flame shaped haemorrhages

9

What is grade 4 hypertensive retinopathy?

Grade 3 with pappiloedema

10

What might urinalysis show?

Proteinuria, heamaturea due to renal damage

11

What other investigation might you want to do?

Urea and creatinine levels, CXR (cardiomegaly), ECG and echo

12

Treatment is aimed at keeping BP to what?

Below 140/90

13

If diabetic what is the BP aim?

Below 130/85

14

What are the three first line anti hypertensives?

ACEIs, CCBs, thiazide diuretics

15

What drugs may be added I'd all three first line drugs are being used?

Alpha blockers, beta blockers, loop diuretic

16

What is malignant hypertension?

A diastolic of over 130

17

What does malignant hypertension cause?

Acute vascular damage and encepahlopathy

18

What percentage of secondary hypertensives have a renal cause?

80%

19

Name 5 causes of secondary hypertension?

Renal artery stenosis, chronic glomerulonephritis, chronic pyelonephritis, poly cystic kidney disease, phaechromacytoma, conn's syndrome (hyper aldosteronism), coarctation of the aorta, pregnancy, oral contraceptive, steroids, ciclasporin

20

When should you suspect secondary especially?

In young patients under 40

21

What investigations would you do for secondary?

U and Es, urinalysis, cortisol, growth hormone, urinary catecholamines, CXR, MRI

22

Difference between secondary and essential management?

Treat the cause but otherwise the same

23

What is the definition of hypertension?

Hypertension is a systolic BP of over 140 or a diastolic of over 90