Hypertension

Question 1

Blood pressure=

Answer 1

Cardiac Output* Peripheral Vascular Resistance

Question 2

Parameters of grade 1 hypertension

Answer 2

140-159/90-99

Question 3

Parameters of grade 2 hypertension

Answer 3

160-179/100-109

Question 4

Parameters of grade 3 hypertension

Answer 4

> 180/>110

Question 5

Parameters of prehypertension

Answer 5

130-139/85-89

Question 6

Parameters of isolated systolic hypertension

Answer 6

systolic >140

diastolic <90

Question 7

Tretatment for isolated systolic hypertension

Answer 7

Lifestyle interventions- less salt, weight loos, physical activity
Drugs only used if lifestyle changes are unsuccesful

Question 8

Parameters of hypotension

Answer 8

90/60 and less

Question 9

Parameters of postural hypotension

Answer 9

Systoli decrease >20mmHg when standing

Diastolic decrease >10mmhG if associated with fainting

Question 10

How does being hypertensive change ones risk of stroke?

Answer 10

Sixfold increase in stroke

Question 11

How does being hypertensive change ones risk of cardiac death

Answer 11

Threefold increase in cardiac death

Question 12

How does being hypertensive change ones risk of developing peripheral arterial disease

Answer 12

Doubles

Question 13

Hypertension leads to which kind of ventricular hypertrophy?

Answer 13

Concentric

Question 14

What signs of damage in the retina can be blamed on hypertension?

Answer 14

Arteriolar narrowing and abnormalities at point where arterioles and venules cross

Question 15

What is primary hypertension? % of cases of hypertension are primary?

Answer 15

Idiopathic- no underlying cause

90-95% of cases

Question 16

What is secondary hypertension

Answer 16

Clear underlying cause

5% of cases

Question 17

Name some causes of secondary hypertension

Answer 17

Renal disease
Endocrine disease
Coarctation of aorta
Hormonal oral contraceptives
Thyroid

Question 18

Why should dietary salt restriction be a treatment of hypertension

Answer 18

because high renin and angiotensin levels lead to excess sodium retention

Question 19

What is hyponatremia

Answer 19

Extracellular fluid sodium<135mmols/l

Question 20

Symptoms of mild hyponatremia

Answer 20

Loss of energy and fatigue
Confusion
Muscle weakness

Question 21

Symptoms of severe hyponatremia

Answer 21

Nausea and vomiting
Headaches
Spasms
Restlessness and irritability
Seizures
Coma
(all due to brian swelling)

Question 22

Suspected reasons so many diabetes patients are hypertensive?

Answer 22

Diabetes damages kidneys and induces excess renin release

Question 23

What causes the link between obesity and hypertension? (3)

Answer 23

1- obesity increases renal renin release, angiotensin formation and sodium retention
2- high levels of leptin due to increased fat cells increase sympathetic vasoconstriction
3- obesity is associated with hyperinsulinaemia

Question 24

First line for hypertensive diabetics?

Answer 24

ACE inhibitors of angiotenis receptor blockers instead of diuretics

Question 25

First line for hypertensive obese people?

Answer 25

Exercise

Question 26

First line for white people or people <55 years old?

Answer 26

ACE inibitor or low cost angiotensin II receptor blocker

Question 27

First line for black or african caribbean and >55 years old>

Answer 27

Calcium channel blocker

Question 28

When may beta blockers be prescribed (usually not first step)

Answer 28

Younger people, particularly if intolerant to ACE inhibitors and angiotensin II receptor antagnosis, women of child bearing potential people with increased sympathetic drive