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Cardiology > Hypertension > Flashcards

Hypertension Flashcards

1
Q

What are the blood pressure measurements required to make a diagnosis of hypertension?

A

140/90mmHg

135/85mmHg (with home readings)

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2
Q

What is the most common cause of hypertension?

A

Primary (essential) hypertension - 95%

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3
Q

What are the secondary causes of hypertension?

A

Renal disease
Obesity
Pregnancy induced (pre-eclampsia)
Endocrine (Conn’s Syndrome)

ROPE

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4
Q

What is the test for Conn’s syndrome?

A

Renin:Aldosterone ratio blood test

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5
Q

What are the complications of hypertension

A 
Ischaemic heart disease
Cerebrovascular accidents
Hypertensive retinopathy
Hypertensive nephropathy
Heart failure
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6
Q

How often should hypertension be screened for?

A

Every 5 years

Every year in patients with T2DM

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7
Q

When should 24-hour ambulatory blood pressure monitoring be performed?

A

In patients with a clinic blood pressure reading between 140/90mmHg and 180/120mmHg

Home readings may also be used

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8
Q

How is the ‘white coat effect’ defined?

A

More than a 20/10mmHg difference in blood pressure from clinic and ambulatory/home readings.

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9
Q

What are the stages of hypertension?

A

Stage 1 hypertension: >140/90 (clinic)
>135/85 (ambulatory

Stage 2 hypertension: >160/100 (clinic)
>150/95 (ambulatory

Stage 3 hypertension: >180/120 (clinic)

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10
Q

What investigations should patients with newly diagnosed hypertension receive to look for end-organ damage?

A 
Urine albumin:creatinine ratio
Urine dipstick
HbA1c
Blood lipid levels
Renal bloods
Fundus examination
ECG
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11
Q

What medications may be used to treat high blood pressure?

A

ACE inhibitor / ARBs
Beta blocker
Calcium channel blocker
Diuretics

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12
Q

What class of drug does Ramipril belong to?

A

ACE inhibitors

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13
Q

What class of drug does Bisoprolol belong to?

A

Beta blockers

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14
Q

What class of drug does Amlodipine belong to?

A

Calcium-channel blockers

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15
Q

What class of drug does Indapamide belong to?

A

Thiazide diuretics

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16
Q

What class of drug does Candasartan belong to?

A

Angiotensin II Receptor Blocker (ARB)

17
Q

In what instances would candasartan be used instead of ramipril?

A

Intolerance (e.g. dry cough)

Patients of African or Afro-Caribbean descent

18
Q

Who is medical management for hypertension offered to?

A

All patients with stage 2 hypertension

Patients with stage 1 hypertension and a QRISK >10% or diabetes/CVD/renal disease (if under 80 years)

19
Q

What is the first line management for a 55 year old caucasian patient?

A

ACE inhibitor

20
Q

What is the first line management for a 56 year old caucasian patient?

A

Calcium-channel blocker

21
Q

What is the first line management for a 35 year old caucasian patient?

A

ACE inhibitor

22
Q

What is the first line management for a 65 year old caucasian patient?

A

Calcium-channel blocker

23
Q

What is the first line management for a 55 year old African patient?

A

Calcium-channel blocker

24
Q

What is the first line management for a 65 year old African patient?

A

Calcium-channel blocker

25
Q

What is the first line management for a 35 year old African patient?

A

Calcium-channel blocker

26
Q

What is the second line management for hypertension?

A

Addition of what was not offered in step one (therefore ACE inhibitor + Calcium-channel blocker)

27
Q

What is the third line management for hypertension?

A

Addition of a diuretic (e.g. Indapamide)

28
Q

What is the fourth line management for hypertension?

A

Addition of either:

Potassium-sparing diuretic (if serum potassium is < 4.5mmol/L)

Alpha-blocker or Beta-blocker (if serum potassium is > 4.5mmol/L)

29
Q

What class of drug does Doxazosin belong to?

A

Alpha blockers

30
Q

How does spironolactone work?

A

It blocks the action of aldosterone in the kidneys. This results in increased sodium excretion and potassium reabsorption.

31
Q

Which hypertension drugs may cause a hyperkalaemia?

A

Spironolactone
ACE inhibitors
ARBs

32
Q

What is the target blood pressure for a patient <80?

A

140/90mmHg

33
Q

What is the target blood pressure for a patient >80?

A

150/90mmHg

Cardiology (10 decks)

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