Tutorial 16 - Hypertension, CKD and hyperlipidemia

Question 1

What is hypertension ?

Answer 1

• Hypertension is the medical term for high blood pressure.
• Grade 1: 140-159 / 90-99
• Grade 2 : 160-179 / 100-109
• Grade 3: > 180 / >110
• Make diagnosis of hypertension based on repeated in office readings or repeated at home +/- ambulatory readings.

Question 2

What is hyperlipidaemia and what is QRISK?

Answer 2

• high lipid levels
• Diagnosed following blood test
• The QRISK is a an algorithm for predicting the chance of someone developing CVD in the next 10 years. A percent above 10 is considered significant and worth treating with statins etc.

Question 3

What are the symptoms of hypertension?

Answer 3

• Commonly hypertension is silent in nature - it does not present with any symptoms.
• If its severe it can present with headaches and blurred vision.

Question 4

What lifestyle advice can be given to someone with hypertension?

Answer 4

• Reduce salt intake
• Increase activity/exercise
• Smoking cessation
• Limit alcohol consumption
• Lose weight if obese/overweight

Question 5

What medication is advised for hypertension?

Answer 5

Question 6

What follow up should be provided?

Answer 6

• At 3-6 month intervals ask patient too book in for a review.
• Where we can access if blood pressure is coming down, if medication is working / any side effects and how they are coping with lifestyle changes etc.

Question 7

What is CKD?

Answer 7

• Reduced kidney function which has been present for over 3 months.

Question 8

How does CKD present?

Answer 8

• Swollen ankles (fluid retention)
• Itchiness
• Shortness of breath (reduced erythropoietin)
• Nocturia (inability to concentrate urine)
• Blood in the urine

Question 9

How is CKD diagnosed?

Answer 9

• Presence of risk factors (obesity, smoker, co-morbidity I,e. diabetes or hypertension )
• Presence of symptoms (which indicate late stage CKD)
• Raised serum creatinine or serum EGFR below 60

Question 10

Management of CKD?

Answer 10

• Management of risk factors , mainly hypertension and diabetes.
• If these conditions are managed better than progression of CKD should slow down.
• Healthy lifestyle advice (smoking and alcohol cessation, healthy diet, exercise, weight loss if overweight).