What is the main driver of hypertension risk?
Assessment for hypertension?
History Family history Smoking CV examination Repeated BPs Examine fundi?
Risk factors in risk factor calculator?
Age Gender Family member with CVD under 60 Chronic kidney disease Suffered atrial fibrillation? Cholesterol (HDL done separately) Diabetes Blood pressure treatment Systolic BP Smoker?
Other risk factors of hypertension?
Left ventricular hypertension Creatinine raised Albuminuria/microalbuminuria Retinoptathy
What does CV mortality risk double with?
Each20/10mmHg of blood pressure Increase
Hypertension is likely to affect most of us. True or false?
Avoidable deaths most popular causes?
Tobacco Hypertension Alcohol Cholesterol Obesity Low fruit and veg Sloth Illicit drugs Unsafe sex
The level of Blood pressure where treatment can do more harm than good
Hypertension must be measured using?
ABPM (Ambulatory Blood Pressure Monitoring ) - When your bood pressure is being measured moving around , living every day life over usually 24 hours. or HBPM - Home measuring BP
When using ABPM to confirm diagnosis ensure that you...?
Have at least 2 measurements per hour during the persons usual walking hours
When using HBPM to confirm a diagnosis you must ensure that...?
There is 2 consecutive seated measurements, 1 minute apart BP is recorded twice a day for at least 4 days preferably 7 Measurements on the first day are discarded and average is taken of the rest
Definition of stage 1 hypertension?
Clinical BP is 140/90 mmHg or higher ABPM or HBPM daytime average is 135/85mmHg or higher
Definition of stage 2 hypertension?
Clinic BP of 160/100mmHg or higher ABPM or HBPM daytime average is 150/95mmHg or higher
Definition of severe hypertension?
Clinic BP is 180mmHg or higher Clinic diastolic BP is 110mmHg or higher
Assessing cardiovascular risk protocol?
Estimation of CV risk to discuss prognosis and healthcare options - offer to - -Test urine for presence of protein -Take blood to measure glucose, electrolytes, creatinine, estimated glomerular filtration rate and cholesterol -Examine fundi for hypertensive retinopathy - Arrange 12- lead ECG
Assessment for hypertension?
Medical History Family History of premature CV disease Smoking CV examination Repeated BPs Examine fundi
Grade 1 hypertensive retinopathy?
Slight or modest narrowing of the retinal arterioles with arteriovenous ratio >_1:2
Grade 2 hypertensive retinopathy?
Modest to severe narrowing of the retinal arterioles (focal or generalized), with an arteriovenous ratio
Grade 3 hypertensive retinopathy?
Bilateral soft exudates or flame shaped haemorrhages
Grade 4 hypertensive retinopathy?
Bilateral optic nerve oedema
When monitoring treatment in patients?
Use clinic blood pressure measurements to monitor response to treatment . Aim for target pressure below -140/90mmHg in people aged under 80 - 150/90 in people over 80
Is BP genetically determined?
Twin studies show 30-50% of BP variability is genetically determined
Common causes of secondary hypertension?
Renal disease Obstructive sleep apnoea Aldosteronism Reno-vascular disease
Uncommon causes of secondary hypertension?
Cushing's Pheochromocytoma Hyperparathyroidism Aortic coarctation Intracranial tumor
Different studies ideas on treatment of renal artery stenosis?
Stenting is no benefit Revascularization has no benefit- substantial risk
What grade 4 retinopathy looks with the 4 signs