Management of hypertension Flashcards
(38 cards)
in most patients with hypertension, what is the target blood pressure to aim for?
140/90mmHg and if tolerated 130/80mmHg or lower in most patines
in people over age of 65 and diabetes, what is the target blood pressure to aim fo?
= 140-130mmHg but NOT < 120mmHg
in very old people, what is the target blood pressure to aim for?
= 140-130mmHg but NOT< 130mmHg
when should alcohol reduction be recommended for prevention & treatment of hypertension?
amongst heavy drinkers
for every kilogram of weight lost, how much does this Lower the blood pressure?
1mmHg is lots for every kg
if you have a no salt added diet, how does this reduce blood pressure?
reduces BP by 2-4mmHg
reduction in what ion may also reduce long term risk of CV events?
long term sodium reduction
what activity reduces blood pressure 3.8/2.6mmHg?
aerobic exercise
what is the relationship between proportional risk reduction and absolute level of risk factor?
proportional risk reduction is INDEPENDENT of the absolute level of the risk factor
true or false.
everybody is hypertensive & dyslipidaemic.
True
what is the main benefit of anti-hypertensive therapies due to?
due to BP lowering
name 5 generic BP drugs?
1) thiazide diuretics
2) ACE inhibitors/ARBs
3) calcium channel blockers
4) beta blockers
5) spironolactone, alpha blockers, centrally acting, older drugs
what are 5 targeted BP drugs?
1) B blockers (Ca blockers) in angina
2) ACEI & B blockers in CCF
3) ACEI/ARBs in diabetic nephropathy
4) Alpha blockers in prostatism
5) thiazide in elderly
6) others
in people under age of 55 what is the first step treatment should they be given?
A
= ACE inhibitor
OR
= low cost angiotensin II receptor blocker (ARB)
in people over age of 55 or black person of African or Caribbean family origin what is the first step should be given?
C
= calcium channel blockers (CCB)
what is the step 2 in treatment for hypersensitive patients?
A + C
= ACE inhibitor or low cost angiotensin II receptor blockers
AND
= calcium channel blocker
what is step 3 in treatment.for hypersensitive patients?
A + C + D = ACE inhibitor or low cost angiotensin II receptor blockers AND = calcium channel blocker AND = thiazide like diuretics
what is step 4 also known as?
resistant hypertension
what needs to be done in steps 4?
= ACE inhibitor or low cost angiotensin II receptor blockers AND = calcium channel blocker AND = thiazide like diuretics
+ further diuretic or alpha or beta blocker
what is one of the main consequences of using a diuretic?
low potassium levels = hyperkalaemia
if diuretics still need to be used, what should also be given to avoid potassium levels getting to 4.5mmol/l lower?
= low dose spironolactone (25mg once daily)
if at step 4, further diuretics are not tolerated, what could be used?
an alpha or beta blocker.
how many more times effective is adding a drug than titrating?
5x more effective
true or false.
Starting with two drugs is always better than starting with one.
True
