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Jamie Cardiovascular Pathology > Hypertension > Flashcards

Flashcards in Hypertension Deck (53):
1

What is the definition of hypertension?

The blood pressure at which the benefits of treatment outweigh the risks

2

What BP is Stage 1 hypertension in a clinical setting?

140/90 mmHg

3

What BP is Stage 2 hypertension in a clinical setting?

160/100 mmHg

4

What BP is severe hypertension in a clinical setting?

180/110 mmHg

5

What gender is at a higher risk of getting hypertension?

Maleds

6

What are 5 medical risk factors for Hypertension?

Diabetes
Renal disease
Previous MI or stroke
Hyperlipidaemia
Left ventricular hypertrophy

7

How is blood pressure affected by age

BP rises with age

8

What effect does reducing salt intake have on hypertensive individuals?

It lowers blood pressure

9

What effect do small amounts of alcohol have on BP?

Decreases BP

10

What effect do large amounts of alcohol have on BP?

Increases BP

11

What is the most important non-pharmacological measure that can be taken for treating hypertension?

Weight reduction

12

What is the relationship between birth weight and hypertension?

The lower the birth weight, the higher risk for developing hypertension later in life

13

What is the racial influence on blood pressure?

Caucasians have lower BP than black population

14

What is the relationship between black populations and salt intake?

Black people are higher salt retainers

15

What are the effects of sustained hypertension?

End-organ damage (blood vessels, heart and kidney)

16

What are 3 organ-related areas of disease that can be a cause for secondary hypertension?

Renal
Endocrine
Vascular

17

What are 3 types of drugs that can induce hypertension?

NSAIDs
Oral contraceptive
Corticosteroids

18

What condition in pregnancy can cause hypertension?

Pre-eclampsia

19

What night time respiratory condition can be a cause for hypertension?

Sleep Apnoea

20

What are 2 of the main endocrine conditions that can cause hypertension?

Conn's syndrome
Cushings disease

21

What blood pressure apparatus must be used to identify hypertension in the clinic?

ABPM (Ambulatory blood pressure monitoring)

22

What blood pressure apparatus must be used to identify hypertension at home?

HBPM (Home blood pressure monitoring)

23

What 2 actions should be taken in clinic when hypertension is identified?

Assess end organ damage
Screen for treatable causes

24

What is the stepped approach?

To use low doses of medication and add on to the current medication as opposed to changing it

25

What are the 4 main categories of drug treatments for hypertensive patients?

AVE inhibitor
ARB
Calcium channel blocker
Thiazide - type diuretic

26

When should under 80 Stage 1 hypertensives be offered treatment?

When there is an additional problem/risk factor (i.e. organ damage/diabetes)

27

What drug should be used as step 1 in over 55s and black people?

CCB

28

What drug should be used as step 1 in under 55s? (2)

ACE indibitor
ARB

29

What drug should be used as a step 2 in all occasions?

Thiazide-type diuretic

30

What is Step 3 treatment of hypertension?

CCB, ACEI and diuretic

31

What is step 4 treatment if the blood potassium level is 4.5mmol/l or lower?

Further diuretic with low-dose spironolactone

32

What is step 4 treatment if the blood potassium level is higher than 4.5mmol/l?

High does thazide diuretic treatment

33

What is the the function of ACE inhibitors?

Competitively inhibits angiotensin converting enzyme (ACE)

34

What is the function of ACE?

Converts angiotensin I to angiotensin II

35

What are 2 examples of ACE inhibitors?

Ramipril
Perindopril

36

What are 2 contraindications of ACEI?

Renal failure
Renal artery stenosis

37

What are 3 adverse drug effects of ACEI?

Cough
Taste disturbance
Renal impairment

38

What is the function of ARBs?

Angiotensin II antagonists that competitively block the actions of angiotensin II

39

What are 2 examples of ARBs

Losartan
Valsartan

40

What is a medical benefit of ARBs over ACEI?

ARBs don't produce a cough

41

What are the 2 types of CCB?

Vasodilator
Rate limiting

42

What are 2 examples of vasodilator CCBs?

Amlodipine
Felodipine

43

What are 2 examples of rate limiting CCBs?

Verapamil
Diltiazem

44

How to CCBs work?

They block L-type calcium channels which reduces cardiac output

45

In what demographics should vasodilating CCBs be used? (2)

Over 55s
Women of child bearing age

46

What are the contraindications for CCBs (1) and those specific to rate limiting CCBs? (2)

Acute MI
(Heart failure, bradycardia)

47

What are 4 adverse drug reactions reactions of CCBs?

Flushing
Headache
Angle oedema
Indigestion

48

What are 2 adverse drug reactions specific to rate limiting CCBs?

Bradycardia
Constipation

49

What are 2 examples of thiazide-type diuretics?

Indapamide
Clortalidone

50

How do thiazide-type diuretics work?

They block reabsorption of sodium and enhave urinary sodium loss

51

What are 2 adverse drug reactions of thiazide-type diuretics?

Gout
Impotence

52

What hypertension drugs should be used during pregnancy? (2)

Thiazide-type diuretics
amlodipine

53

What is accelerated hypertension?

A resent significant increase in BP that is associated with target organ damage