Hypertension Flashcards
(49 cards)
true/false - automatic BP machines still work if pulse is irregular
false - do a manual pressure
in what environment would you ideally do a BP reading?
quiet, relaxed environment with patient seated
Is a clinic BP good enough to diagnose hypertension?
no, you have to take a ABPM or HBPM
what is ABPM
Ambulatory blood pressure measuring
2 readings per hour for a patients waking day
what is HBPM
Home blood pressure measuring
3 readings twice a day for 7 days
Lowest value taken
what is white coat hypertension
high blood pressure in clinic that is not normally high
what is masked hypertension
low blood pressure in clinic that is normally high
What is stage I hypertension
clinic BP - 140/90 mmHg
ABPM/HBPM - 135/85 mmHg
what is stage II hypertension
clinic BP - 160/100 mmHg
ABPM/HBPM - 150/95 mmHg
what is severe high blood pressure
clinic BP - 180/110 mmHg
Does everyone with hypertension get treatment?
no, only those with stage II or stage I with suspected organ failure or CVD risk factor >20%
in addition to testing for CVD risk, what other tests would you do?
Fundoscopy 12-lead ECG urinalysis for protein glucose fasting creatinine/albumin U+E cholesterol and TAG
end organ damage signs and types
LVH - ST depression and raised QRS
Albuminuria - renal failure
hypertensive retinopathy
raised creatinine
what causes hypertension
secondary causes
genes
environment
a -5 mmHg diastolic pressure causes…
decrease in stroke by 40% and CHD risk by 25%
Causes of secondary hypertension
OSA renal disease renovascular disease fibromuscular dysplasia cushing's phenochromocytoma hyperparathyroidism aortic coarctation intracranial tumour Conn's syndrome
ways to non-pharmacologically reduce CV risk
Reduce alcohol consumption smoking cessation lose weight if obese reduce salt intake DASH diet
how many people have a salt sensitivity relating to BP?
25%
If a high risk normotensive with normal cholesterol was in your practice, would you prescribe a statin to lower both?
yes!
first line antihypertensive for under 55
ACEI or ARB or BB for pregnant/fertile women
first line antihypertensive for over 55/black patient any age
CCB or diuretic
second line antihypertensives if response nil
ACEI/ARB and CCB OR ACEI/ARB and diuretic
third line antihypertensives if response nil
ACEI/ARB, CCB and diuretic
antihypertensives if all other lines fails
alpha/beta blocker
Spironolactone if resistant - low slow dose
