Hypertension Flashcards
(39 cards)
Define hypertension?
blood pressure more than 140/90mmHg
what are the causes of hypertension?
Primary (essential) – treat the hypertension itself
- Essential or idiopathic hypertension
- Unknown cause
- Responsible for > 90% of cases
Secondary causes
what are the secondary causes of hypertension?
Renal
- renal artery stenosis
- Chronic glomerulonephritis
- pyelonephritis
- polycystic kidney disease
- Renal failure
Pregnancy
- pre-eclampsia
Enocrine
- diabetes
- hyperthyroidism
- cushing’s
- conn’s
- hyperparathyroidism
- phaeochromocytoma
- congenital adrenal hyperplasia
Cardio
- coarction of aorta
- increased intravascular volume
Drugs
- Sympathomimetics
- corticosteroids
- oral contraceptives
what is isolated systolic hypertension?
Most common form in the UK – affects >50% of the over 60s
Due to stiffening of the large arteries (arteriosclerosis)
what is malignant ( accelerated phase) hypetension?
A rapid rise in BP leading to vascular damage (pathological hallmark is fibrinoid necrosis)
Usually there is severe hypertension + bilateral retinal haemorrhages and exudates; papilloedema may or may not be present
what is a q risk score?
% chance of having a CV event in the next 10 years (heart attack or stroke)
Looks at
- Age
- Gender
- Smoker
- DM
- BP
- Treatment for BP
- Cholesterol
- HDL level
- CKD
- FH of CHD
Use to tell patient to convince them to change lifestyle
If 100 people had a similar presentation as you, then ___ of them would have a risk of a heart attack or stroke
outline the diagnosis of hypertension?

outline the classification of hypertension?

outline the lifestyle management for hypertension?
Stop smoking
Lose weight
Reduce alcohol intake
Reduce dietary sodium
outline the management of hypertension?

what are the BP targets for over 80 years old and under 80 years old?

what is the mechanism of action of ACE inhibitors?
inhibit conversion of angiotensin I to angiotensin II
what are the side effects of ACE inhibitors?
cough
angiooedema
hyperkalaemia
renal failure
what are the important notes for ACE inhibitors?
first line treatment in younger patients ( less than 55)
less effective in Afro-carribean patients
must be avoided in pregnant women
check renal function 2-3 weeks after starting ( risk of worsening renal function in patients with renovascular disease)
drug names end in -pril
what is the mechanism of action of angiotensin II receptor blockers?
block effects of angiotensin II at the AT1 receptor
what are the side effects of angiotensin II receptor blocker?
hyperkalaemia
what are the notes for angiotensin II receptor blockers?
generally used when patients have not tolerated an ACE inhibitor-> Usually due to development of cough
drugs names end in -sartan
what is the mechanism of action of calcium channel blocker ?
block voltage gated calcium channels relaxing vascular smooth muscle and force of myocaridal contraction
what are the side effects of calcium channel blockers?
flushing
ankle oedema
headache
gum hyperplasia
what are the notes for calcium channel blockers?
first line treatment in odler patients ( more than 55)
what is the mechanism of action of thiazide like diuretic?
inhibit sodium absorption at the beginning of the distal convoluted tubule
what are the side effects of thiazide type diuretic?
hyponatraemia
hypokalaemia
dehydration
ECG changed/ arrythmia
what are the side effects of spironolactone?
hyperkalaemia
gynaecomastia- decreases testosterone production and increases peripheral conversion of testosterone to oestrogen
