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Hypertension Notes

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This is an extract of our Hypertension document, which we sell as part of our Cardiology Notes collection written by the top tier of University Of Leicester students.

The following is a more accessble plain text extract of the PDF sample above, taken from our Cardiology Notes. Due to the challenges of extracting text from PDFs, it will have odd formatting:

Hypertension "Blood pressure >140/90mmHg" Incidence increases with age Pathophysiology
- 95% 'essential' o Combination of various genetic and environmental factors
- 5% 'secondary' o Identifiable cause suggested by;
? Renal dysfunction
? Young age <30yrs
? Severe treatment-resistant hypertension
? Hypokalaemia (in absence of diuretics) (Causes = high glucocorticoids (cushings), high aldosterone (Conn's) high renin (renal artery stenosis) coarctation of aorta (radio-femoral delay) Clinical features
- Usually asymptomatic until end-organ damage occurs
- Most headaches in hypertension are NOT related to BP
- Malignant hypertension may present with headache and vision loss (papilloedema) Effects of hypertension
- Long term risk of hypertension is end-organ damage o Cerebrovascular disease
? Thrombotic and haemorrhagic stroke o Vascular disease
? Coronary artery disease o Left ventricular hypertrophy
? Compensatory response to chronic hypertension
? Independent predictor of cardiac death from ventricular arrhythmias, heart failure and MI o Renal failure
? Hypertension leads to reno-vascular damage and glomerular loss Investigations
- Confirm hypertension o Repeat BP measurement/ambulatory 24hour readings
- Assess for secondary care o Renal disease (urine dip, U+E for creatinine, renal artery imaging, renal size on ultrasound) o Exclude coarctation (clinical examination, CXR) o Exclude hypokalaemia (cushings and conn's syndrome)
- Assess for end-organ damage o ECG o Cardiac echo (LV hypertrophy) o Renal function Treatment Aim = remove excess stroke risk and half the coronary artery risk

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