Flashcards in Hypertension Deck (37)
A blood pressure of what is the most widely accepted definition of hypertension?
More than 140mmHg systolic and/or 90mmHg diastolic
Which ethnic group has the highest prevalence of hypertension?
What are some modifiable risk factors for hypertension?
Obesity, smoking, alcohol, high salt intake
If a patient has a one-off blood pressure reading of > 140/90 in clinic, what should you do next?
Repeat the test (if the second reading varies a lot from the first, repeat it again)
What investigation must be done in order to diagnose hypertension?
Home or ambulatory blood pressure monitoring
On home or ambulatory blood pressure monitoring, what result would be diagnostic of hypertension?
An average waking blood pressure of > 135/85mmHg
What is a vascular condition which can cause secondary hypertension?
Coarctation of the aorta
What are some medications that can cause secondary hypertension?
HRT/COCP, steroids, NSAIDs
What is the definition of accelerated hypertension?
BP > 180/110mmHg in combination with severe retinopathy
What medications can potentially be used in cases of hypertensive emergencies?
IV labetalol or GTN
What is the definition of malignant hypertension? What clinical sign can be seen in these cases?
Diastolic pressure > 130-140mmHg / papilloedema
If an ACE inhibitor, Ca channel blocker and thiazide diuretic are not adequately controlling hypertension, and the potassium level is < 4.5mmol/L, what drug(s) should be considered next?
Low dose spironolactone
If an ACE inhibitor, Ca channel blocker and thiazide diuretic are not adequately controlling hypertension, and the potassium level is > 4.5mmol/L, what drug(s) should be considered next?
Alpha or beta blocker
What drug is especially effective for treating resistant hypertension?
What is a fairly common side effect of ACE inhibitors? If this occurs, what group of drugs should be used instead?
Dry cough / ARB
What is the target blood pressure in adults aged < 80?
What is the target blood pressure in adults aged > 80?
What is the target blood pressure in adults with diabetes?
Which organ systems are most likely to be affected by hypertension?
Cardiovascular, renal, neurological and ophthalmic
What side effect of the use of anti-hypertensive medications is very common in the elderly?
What are some drugs that can be used to manage hypertension in pregnancy?
Labetalol, nifedipine, hydralazine, methyldopa
Metabolic syndrome can be diagnosed when 3 out of what 4 features are present?
Obesity, hypertension, dyslipidaemia, insulin resistance
What are some features that would make you suspicious of secondary hypertension?
Early onset (< 40), unexpectedly severe, resistant hypertension
What are some renal causes of secondary hypertension?
CKD, renal artery stenosis, PKD
What are some endocrine causes of secondary hypertension?
Phaeochromocytoma, Conn's syndrome, Cushing's syndrome
What is some lifestyle advice that should be offered to patients with hypertension?
Lose weight, exercise, stop smoking, reduce alcohol, low salt diet (ideally to < 6g/day)
What is a common cause of apparently resistant hypertension?
Non-compliance with medication
What is the first line drug for the management of hypertension in those aged < 55?
ACE inhibitor / ARB
What is the first line drug for the management of hypertension in those aged > 55?
Ca channel blocker