Hypertension

Question 1

What are the main risk factors for hypertension?

Answer 1

1. Age
2. Race (African»_space; caucasian)
3. Family history
4. Obesity
5. Inactivity
6. Active smoking
7. High-sodium diet
8. Low-potassium diet
9. Alcohol
10. Stress

Question 2

What are the different types of hypertension?

Answer 2

1. Primary hypertension

2. Secondary hypertension

Question 3

What are underlying causes of secondary hypertension?

Answer 3

• Obstructive sleep apnea
• Kidney disease
  
  • Renal artery stenosis
  • Polycystic kidney disease
• Endocrine dysfunction
  
  • Primary hyperaldosteronism
  • Phaeochromocytoma
  • Cushing’s disease
• Thyroid problems
• Congenital heart disease
• Illegal drugs, such as cocaine and amphetamines

Question 4

What are complications of hypertension?

Answer 4

MI
Stroke
Aneurysm
Heart failure
Nephropathy 
Metabolic syndrome

Question 5

How is hypertension diagnosed?

Answer 5

1. Clinical reading > 140/90
2. Offer ABMP or HBPM

If BP >135/80: stage I hypertension, if no comorbidities: no treatment

If BP >150/95: stage II hypertension –> treat

Question 6

What is a hypertensive crisis?

Answer 6

A blood pressure measurement higher than 180/120 mm Hg is an emergency situation that requires urgent medical care

Question 7

What are pieces of lifestyle advice given to people with hypertension?

Answer 7

1. Cut salt intake
2. Lose weight
3. Limit alcohol intake
4. Exercise regularly
5. Cut down on caffeine
6. Stop smoking

Question 8

What are common side effects of calcium channel blockers?

Answer 8

Ankle oedema, flushing, headache

Question 9

What are common side effects of ACE-I?

Answer 9

Dry cough, oedema, hyperkalaemia

Question 10

What are common side effects of thiazide diuretics?

Answer 10

Hyponatraemia, hypokalaemia

Question 11

What is malignant hypertension?

Answer 11

High blood pressure with symptoms and signs indicative of acute impairment of one or more organ system – typically with a systolic BP of > 180 mmHg

Question 12

What are the symptoms of malignant hypertension?

Answer 12

1. Chest pain
2. Headache
3. Dyspnoea
4. Anxiety
5. Palpitations

Question 13

What are causes of malignant hypertension?

Answer 13

1. Discontinuation of medication
2. Drug use
3. Head trauma
4. Eclampsia

Question 14

How would you treat malignant hypertension?

Answer 14

IV sodium nitroprusside injection 0.5-1.5 micrograms/kg/minute