Flashcards in Session 4 - Hypertension Deck (9)
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1
What systems provide physiological control of blood pressure?
Autonomic nervous system
Renin-angiotensin-aldosterone system
Others:
- bradykinin
- endothelin
- nitric oxide
- atrial natriuretic peptide
2
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
3
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
4
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)
5
What is the first line pharmacological treatment for hypertension?
Angiotensin converting enzyme (ACE) inhibitors / Angiotensin receptor blockers (ARB)
Calcium channel blockers
Diuretics
6
Give examples of ACE inhibitors.
Lisinopril
Ramipril
7
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
8
Give examples of Angiotensin Receptor Blockers (ARB).
Losartan
Candesartan
9
