Hypertension and CVS Flashcards
CVS
What to do if clinic BP 140/90- 179/119
offer ABPM
What if clinic reading 180/120 or more
Assess for target organ damage and consider starting drug treatment
Same day review if retinal haemorrhage or pailloedema
repeat in 7 days if no damage
Otherwise same day specialist review + suspected pheochromocytoma
ABPM 135/85-149/94
Lifestyle advice unless has diabetes or high QRISK2 in which case consider starting meds
150/95 or more
Medications - investigate with specialist review if under 40
Drug choice for black patient with diabetes
ACE or ARB
Drug choice black patient
CCB
young white
give ACE or ARB
Diabetics
Always ACE
old (55+)
CCB
What to add when on dual therapy and still hypertensive
Thiazide like diuretic
What to add when on triple therapy already
Low dose spironolactone If K+ <4.5
or alpha/beta blocker if K+ >4.5
Ramipril Dose
By mouth
Adult
Initially 1.25–2.5 mg once daily, increased if necessary up to 10 mg once daily, dose to be increased at intervals of 2–4 weeks.
Amlodipine dose
By mouth
Adult
Initially 5 mg once daily; increased if necessary up to 10 mg once daily.
CCB side effect
Abdominal pain; dizziness; drowsiness; flushing; headache; nausea; palpitations; peripheral oedema; skin reactions; tachycardia; vomiting
Bendroflumathiazide dose
By mouth
Adult
2.5 mg once daily, dose to be taken in the morning, higher doses are rarely necessary.
