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Hypertension (Management (Alternative 1st line: CCB (dihydropyridines)…
Hypertension
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Causes:
Secondary:
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Endocrine disorders e.g. Conn's syndrome, phaeochromocytoma, hyper/hypothyroidism, cushing's
Other: coarctation of the aorta, pregnancy, OSA
Drugs: OCP, NSAID, steroids
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Management
1st line: ACE I
Good in: DM, Heart failure, MI, stroke, PVD
CI: Renal artery stenosis (normally Angiotensin 2 --> vasoconstriction at the efferent (post glomerular) arteriole --> maintaining glomerular filtration pressure), hyperkalaemia, pregnancy
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Non pharmacological: SNAP, lose weight, decrease NaCl, intake (<4-6g per day)
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Other drugs:
Beta blockers
CI: asthma, COPD, heart block, bradycardia, uncontrolled HF, Type 1 DM
Recommended: MI, angina, younger patients, migraine
SE: bronchoconstriction, sexual dysfunction, fatigue, insomnia
Alpha Blockers
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CI: heart failure, orthostatic hypotension, aortic stenosis; relative CI: old people
SE: orthostatic hypotension, weakness
Target BP:
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< 130/80 if there is end organ damage e.g. coronary heart disease, CKD, CVD, DM, proteinuria > 300