hypertension Flashcards
1
Q
what is hypertension?
A
- high sustained arterial pressure
- 140/90
2
Q
what is hypertension a risk factor for?
A
- cerebral haemorrhage
- atheroma
- renal failure
- sudden cardiac death
3
Q
how is blood pressure calculated?
A
- cardiac output x peripheral resistance
4
Q
what is primary hypertension?
A
- 90% of cases
- salt intake -25% salt sensitive
- renin - angiotensin system
- sympathetic activity
5
Q
what is salt sensitive hypertension?
A
- increase in salt = increased BP
- in renal 27 hypertension is usually salt sensitive
6
Q
what are the common causes of secondary hypertension?
A
- renal disease
- endocrine disease
- aortic disease
- renal artery stenosis
- drug therapy
7
Q
how do renal causes cause secondary hypertension?
A
- eg renal artery stenosis
- reduced renal blood flow
- excess renin release
- salt and water overload
8
Q
how do endocrine causes cause secondary hypertension?
A
- adrenal gland hyperfunction/tumours
- conn’s syndrome - excess aldosterone
- cushing syndrome - excess corticosteroid
- phaecochromocytoma - excess noradrenaline
9
Q
what can benign hypertension cause?
A
causes
- left ventricular hypertrophy
- congestive cardiac failure
- increases atheroma
- increases aneurysm rupture
- renal disease
10
Q
what is left ventricular hypertrophy?
A
- increase LV load
- poor perfusion
- interstitial fibrosis
- micro-infarcts
- diastolic dysfunction
11
Q
what are the consequences of benign hypertension?
A
- every 10mmHg of diastolic pressure above 85 double risk of MI
- every 8mmHg of diastolic pressure above 85 double risk of stroke
12
Q
what is malignant hypertension?
A
- diastolic pressure >130-140
- can develop from either benign or secondary hypertension
- needs urgent treatment
- causes cerebral oedema
- acute renal failure
- acute heart failure
13
Q
what is pregnancy associated hypertension?
A
- increased maternal and fetal morbidity/mortality
- ## pre-eclampsia = hypertension and proteinuria
14
Q
when using ABPM to confirm diagnosis, what must you ensure?
A
- at least two measurements per hour during the person’s usual waking ours
15
Q
when using HBPM to confirm diagnosis, what must you ensure?
A
- two consecutive seated measurements, 1 minute apart
- BP is recorded twice a day for at least 4 days and preferably for 7 days
- measurements on the first day as discarded - average value a=of all remaining is used
