Session 4 - Hypertension Flashcards
(9 cards)
What systems provide physiological control of blood pressure?
Autonomic nervous system
Renin-angiotensin-aldosterone system
Others:
- bradykinin
- endothelin
- nitric oxide
- atrial natriuretic peptide
What is the difference between primary (essential) and secondary hypertension?
Primary (essential) hypertension - high blood pressure without any single evident cause
Secondary hypertension - high blood pressure with a discrete, identifiable underlying cause
What are the basic principles for treatment of hypertension?
Identify and treat underlying cause if present.
Identify and treat other cardiovascular sick factors or co-morbidities.
Lifestyle advice/non-pharmacological therapy
Pharmacological therapy
What lifestyle therapy should be given to hypertensive patients?
Patient education
Maintain normal body weight (BMI 20-25 kg/m2)
Reduce salt intake
Limit alcohol consumption
Engage in regular exercise
Consume more than 5 portions of fruit/veg a day
Smoking cessation (no effect on blood pressure, but reduces cardiovascular risk)
Relaxation therapies (reduce blood pressure for a short time, no long term benefit)
What is the first line pharmacological treatment for hypertension?
Angiotensin converting enzyme (ACE) inhibitors / Angiotensin receptor blockers (ARB)
Calcium channel blockers
Diuretics
Give examples of ACE inhibitors.
Lisinopril
Ramipril
What are the side effects of ACE inhibitors?
Main side effect - dry cough
Other important side effects:
- Angio-oedema (rare, but more common in black population)
- renal failure (including renal artery stenosis)
- hyperkalaemia
Give examples of Angiotensin Receptor Blockers (ARB).
Losartan
Candesartan
What are the side effects of angiotensin receptor blockers (ARB)?
They are generally well tolerated with few side effects.
Possible important side effects:
- renal failure
- hyperkalaemia
