Hypertension

• Fill in the blanks

  A) Stage 1

  B) 140/90

  C) 135/85

  D) Stage 2

  E) 160/100

  F) 150/95

  G) Stage 3

  H) 180

  I) 120

  J) Isolated systolic

  K) 160

  L) Accelerated

  M) 180/120

  
• What are the different types of HTN?


  Essential (90%)

  Secondary (10%)
• What are the possible causes of secondary HTN?


  ROPED

  Renal disease

  Obesity

  Pre-eclampsia

  Endocrine

  Drugs (alcohol, steroids, NSAIDs, oestrogen & liquorice)
• What are the signs & symptoms of HTM?


  Usually asymptomatic

  If symptoms present, think hypertensive crisis

  • Headaches
  • Dizziness
  • Blurred vision
  • Nose bleeds
  • SOB
  • Chest pain
  • Cardiac arrhythmia
  • Fundoscopic changes
  • Displaced apex beat
  • S4 heart sound
  • Reduced/absent peripheral pulses
• What are the RFs of HTN?


  Increasing age

  Male

  Ethnicity

  FHx

  Diet

  Smoking

  Alcohol

  Exercise

  Stress

  BMI
• What the Inx for HTN?


  BP

  Obs

  Full Hx & exam

  ECG

  Bloods (FBC, U&Es, LFTs, CRP, HbA1c, lipid profile, fasting glucose)

  Urinalysis (proteinuria or haematuria may indicate renal damage)
• What is a hypertensive crisis?


  BP > 180/120
• What are the possible complications of HTN?


  IHD

  Cerebrovascular accident

  Vascular disease

  Hypertensive retinopathy

  Hypertensive nephropathy

  Vascular dementia

  LV hypertrophy

  HF
• What is management & treatment for HTN?


  Smoking cessation

  Reduce alcohol, caffeine & salt intake

  Regular exercise

  Medication

  • A - ACE inhibitor
  • B - Beta blocker
  • C - Ca+2 channel blocker
  • D - Thiazide-like diuretic
  • ARB (angiotensin II receptor blocker) (not used with ACEi)

  
• What is the treatment of a hypertensive crisis?


  Sodium nitroprusside

  Labetalol

  GTN

  Nicardipine