Hypertension

Question 1

Diagnosis of hypertension

Answer 1

If clinic BP is 140/90 mmHg or higher, offer ambulatory blood pressure monitoring (ABPM) to confirm the diagnosis of hypertension

Question 2

How does APBM work?

Answer 2

At least 2 measurements per day

Question 3

HBPM?

Answer 3

• 2 consecutive seated measurements, 1 minute apart
• do this for 4 days (preferably 7 days)

-measurements from first day are discarded, average of all remaining used

Question 4

Stage 1 hypertension

Answer 4

Clinic BP is 140/90mmHg or higher and

ABPM or HBPM daytime average is 135/85mmHg or higher.

Question 5

Stage 2 hypertension

Answer 5

Clinic BP 160/100mmHg or higher and

ABPM or HBPM daytime average is 150/95mmHg or higher.

Question 6

Severe hypertension

Answer 6

Clinic BP is 180mmHg or higher or

Clinic diastolic BP is 110mmHg or higher.

Question 7

If someone has hypertension, which other tests should you offer?

Answer 7

• Urine for protein
• Blood to measure glucose, electolytes, creatinine, estimated glomerular filtration rate and cholesterol
• Examine FUNDI for retinopathy
• Arrange a 12 lead ECG

Question 8

Main driver of absolute risk for hypertension?

Answer 8

Age

Question 9

What is your CV risk if you have established vascular disease? (e.g. ischaemic heart disease, cerebro-vascular disease, PVD, diabetes)

Answer 9

20%

Question 10

Treatment for stage 1 hypertension

Answer 10

(consider specialist referral if under 40)

• Offer lifestyle interventions
• Offer patient education and interventions to support adherence to treatment
• OFFER ANNUAL review

Question 11

How often should you review people with stage 1 hypertension?

Answer 11

At least annually

Question 12

Treatment for stage 2 hypertension?

Answer 12

Offer anti-hypertensive drug treatment (and everything offered for stage 1 hypertension management)

Question 13

Target clinic blood pressure?

Answer 13

140/90 in people under 80

150/90 in people over 80

Question 14

Target ABPM/HBPM?

Answer 14

135/85 in people under 80

145/85 in people over 80