Hypertension

Question 1

What are the main causes of hypertension?

Answer 1

Primary: 90%, due to obesity, fatty diet, alcohol, lack of exercise, smoking.

Secondary: 10%, due to Conn’s, phaeochromocytoma, acromegaly, sleep apnoea, co-arctation of aorta

Question 2

What is hypertension a risk for developing?

Answer 2

CAD, cerebrovascular disease, PVD, heart failure.

Question 3

What is the classification of hypertension?

Answer 3

Grade 1 = S 140-160 , D 90-100.

Grade 2 = S 160-180, D 100-110

Grade 3 = S >180, D >110

Question 4

What investigations, other than BP, would you do in suspected hypertension?

Answer 4

Glucose/HbA1c
lipids - quantify risk
U+E’s - decreased K in Conn, increased Ca in hyperparathyroid
12 lead ECG can show LVH e.g. end organ damage.
Renin/aldosterone - primary hyperaldosteronism

Question 5

What is treatment for hypertension?

Answer 5

Under 55 and white: ACEi (or ARB)

Over 55 or black: Calcium channel blocker

2nd line: add the opposite.

3rd line: add diuretic.