Hypertension

Question 1

What is the definition of hypertension?

Answer 1

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

Question 2

What BP is Stage 1 hypertension in a clinical setting?

Answer 2

140/90 mmHg

Question 3

What BP is Stage 2 hypertension in a clinical setting?

Answer 3

160/100 mmHg

Question 4

What BP is severe hypertension in a clinical setting?

Answer 4

180/110 mmHg

Question 5

What gender is at a higher risk of getting hypertension?

Answer 5

Maleds

Question 6

What are 5 medical risk factors for Hypertension?

Answer 6

Diabetes
Renal disease
Previous MI or stroke
Hyperlipidaemia 
Left ventricular hypertrophy

Question 7

How is blood pressure affected by age

Answer 7

BP rises with age

Question 8

What effect does reducing salt intake have on hypertensive individuals?

Answer 8

It lowers blood pressure

Question 9

What effect do small amounts of alcohol have on BP?

Answer 9

Decreases BP

Question 10

What effect do large amounts of alcohol have on BP?

Answer 10

Increases BP

Question 11

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

Answer 11

Weight reduction

Question 12

What is the relationship between birth weight and hypertension?

Answer 12

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

Question 13

What is the racial influence on blood pressure?

Answer 13

Caucasians have lower BP than black population

Question 14

What is the relationship between black populations and salt intake?

Answer 14

Black people are higher salt retainers

Question 15

What are the effects of sustained hypertension?

Answer 15

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

Question 16

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

Answer 16

Renal
Endocrine
Vascular

Question 17

What are 3 types of drugs that can induce hypertension?

Answer 17

NSAIDs
Oral contraceptive
Corticosteroids

Question 18

What condition in pregnancy can cause hypertension?

Answer 18

Pre-eclampsia

Question 19

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

Answer 19

Sleep Apnoea

Question 20

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

Answer 20

Conn’s syndrome

Cushings disease

Question 21

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

Answer 21

ABPM (Ambulatory blood pressure monitoring)

Question 22

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

Answer 22

HBPM (Home blood pressure monitoring)

Question 23

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

Answer 23

Assess end organ damage

Screen for treatable causes

Question 24

What is the stepped approach?

Answer 24

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

Question 25

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

Answer 25

AVE inhibitor ARB Calcium channel blocker Thiazide - type diuretic

Question 26

When should under 80 Stage 1 hypertensives be offered treatment?

Answer 26

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

Question 27

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

Answer 27

CCB

Question 28

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

Answer 28

ACE indibitor | ARB

Question 29

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

Answer 29

Thiazide-type diuretic

Question 30

What is Step 3 treatment of hypertension?

Answer 30

CCB, ACEI and diuretic

Question 31

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

Answer 31

Further diuretic with low-dose spironolactone

Question 32

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

Answer 32

High does thazide diuretic treatment

Question 33

What is the the function of ACE inhibitors?

Answer 33

Competitively inhibits angiotensin converting enzyme (ACE)

Question 34

What is the function of ACE?

Answer 34

Converts angiotensin I to angiotensin II

Question 35

What are 2 examples of ACE inhibitors?

Answer 35

Ramipril | Perindopril

Question 36

What are 2 contraindications of ACEI?

Answer 36

Renal failure | Renal artery stenosis

Question 37

What are 3 adverse drug effects of ACEI?

Answer 37

Cough Taste disturbance Renal impairment

Question 38

What is the function of ARBs?

Answer 38

Angiotensin II antagonists that competitively block the actions of angiotensin II

Question 39

What are 2 examples of ARBs

Answer 39

Losartan | Valsartan

Question 40

What is a medical benefit of ARBs over ACEI?

Answer 40

ARBs don't produce a cough

Question 41

What are the 2 types of CCB?

Answer 41

Vasodilator | Rate limiting

Question 42

What are 2 examples of vasodilator CCBs?

Answer 42

Amlodipine | Felodipine

Question 43

What are 2 examples of rate limiting CCBs?

Answer 43

Verapamil | Diltiazem

Question 44

How to CCBs work?

Answer 44

They block L-type calcium channels which reduces cardiac output

Question 45

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

Answer 45

Over 55s | Women of child bearing age

Question 46

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

Answer 46

Acute MI | Heart failure, bradycardia

Question 47

What are 4 adverse drug reactions reactions of CCBs?

Answer 47

Flushing Headache Angle oedema Indigestion

Question 48

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

Answer 48

Bradycardia | Constipation

Question 49

What are 2 examples of thiazide-type diuretics?

Answer 49

Indapamide | Clortalidone

Question 50

How do thiazide-type diuretics work?

Answer 50

They block reabsorption of sodium and enhave urinary sodium loss

Question 51

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

Answer 51

Gout | Impotence

Question 52

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

Answer 52

Thiazide-type diuretics | amlodipine

Question 53

What is accelerated hypertension?

Answer 53

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