. Flashcards
Malignant HTN is defined as
encephalopathy or nephropathy with accompanying papilledema as seen on funduscopic examination.
Hypertension is
systolic BP is 140 mm Hg or diastolic BP is ≥90 mm Hg (or both) on repeated examination
Signs of hypertensive emergency
headache, dizziness, chest pain, dyspnea, blurred vision, and palpitations
Treatment of mild to moderate hypertension
Weight loss Salt restriction Aerobic exercise Reduce alcohol DASH diet Meditterian diet
Treatment of severe hypertension
Diuretics plus ACE/ARB/CCB
African-American patients are least effectively treated with which diuretics
ACE inhibitors.
What is hypertensive emergency ?
Acute onset of severe hypertension with rapidly progressing or worsening symptoms of end organ damage
Diastolic > 120-130
Clinical presentation
Neurologic: encephalopathy, headache, confusion, seizures, subarachnoid or intracerebral hemorrhage
• Cardiac: chest pain, myocardial infarction, palpitations, dyspnea, pulmonary edema, jugular venous distension, gallops
- Nephropathy: acutely progressive hematuria, proteinuria, renal dysfunction
- Retinopathy: papilledema, hemorrhage, blurred vision
Treatment of hypertensive emergency
Nitroprusside and labetolol
Enalapril
If myocardial ischemia use nitroglycerin
The most important point in management of hypertensive emergency is
Is not to lower the pressure too far (e.g., not <95– 100 mm Hg diastolic) so as not to compromise myocardial or cerebral perfusion. The initial goal is to reduce BP by no more than 25% within the first 1−2 hours.
What is secondary hypertension ?
It is hypertension with an identifiable underlying cause
Most common cause of secondary hypertension is ?
Bilateral Renal stenosis
Diagnosis of renal artery stenosis
Captopril renogram
Renam artery duplex US
MR angiography
Treatmnt of RA stenosis
Percutaneous Transluminal angioplasty
Hypertensive urgency
severe elevations in BP that do not exhibit evidence of target-organ
