Flashcards in Hypertension Deck (23):
What blood pressure is classed as Stage 1 hypertension?
140/90 mmHg clinically, and 135/85mmHg at home
What blood pressure is classed as Stage 2 hypertension?
160/100mmHg clinically and 150/95mmHg
What blood pressure is classed as Stage 3 hypertension?
180mmHg systolic or 110mmHg diastolic clinically
What kinds of end organ damage can occur with hypertension?
- Left Ventricular Hypertrophy
- Creatinine Raised
- Albuminuria / microalbuminuria
Which tests should be offered to be people who have been diagnosed with hypertension?
• Test urine for presence of protein
• Take blood to measure glucose, electrolytes, creatinine, estimated glomerular filtration rate and cholesterol
• Examine fundi for hypertensive retinopathy
• Arrange a 12-lead ECG.
What are some of the common and the uncommon causes of secondary hypertension?
- Renal disease
- Obstructive Sleep Apnoea
- Reno-vascular Disease
- Aortic coarctation
- Intracranial tumor
Primary Aldosteronism/Conn's Syndrome
Involves excess production of the hormone aldosterone by the adrenal glands resulting in low renin levels, and excessive reabsorption of sodium and water
Neuroendocrine tumor of the medulla of the adrenal glands that failed to involute after birth. It secretes high amounts of catecholamines, mostly norepinephrine
What level of weight loss is equivalent to taking anti-hypertensives?
6kg is therefore the same as taking anti- hypertensive drugs
By how much does a no added salt diet reduce BP?
By how much does aerobic exercise reduce BP?
What is the difference between absolute and relative risk?
Relative risk is used to compare the risk in two different groups of people. Absolute risk of a disease is your risk of developing the disease over a time period. Can reduce everyone's relative risk of CVS but much harder to reduce absolute risk of CVS. Eg. Reducing relative risk in an 80 year old smoker, would still have a very high absolute risk
True or False: ACE inhibitors should be avoided in pregnant women
True, they are teratogenic
True or False: There are more side effects when using combined therapies than monotherapy
False, there a more side effects with mono therapy
What is the most effective treatment for resistant hypertension?
Spironolactone (start low, go slow)
What are new technologies used with hypertension?
- Renal denervation: minimally invasive, endovascular catheter based procedure using radiofrequency ablation or ultrasound ablation aimed at treating resistant hypertension
- Baroreceptor stimulation: Recently an implantable device to electrically stimulate the carotid baroreceptors, to decrease sympathetic outflow
- Rox coupler: placed between the artery and vein in the upper thigh to allow a calibrated amount of blood to flow between them
BP stays high consistently and doesn’t change much
Blood pressure =
Cardiac output x total peripheral resistance
What percentage of hypertension cases are primary?