clinical case HTN

Question 1

what is prehypertension?

Answer 1

blood pressure 120/80 to 139/89 mmHg

Question 2

is drug therapy recommended for prehypertension?

Answer 2

no (evidence lacking on whether it decreases or prevents cardiovascular events)

Question 3

what are the clinical bottom line for HTN?

Answer 3

1. cardiovascular risk increases as blood pressure increases
2. screen all adults for hypertension at 1 to 2 yr intervals
3. lifestyle modification can delay hypertension + CVD onset
   - -> no evidence for adding pharmacotherapy for prevention

Question 4

drug therapy for volume overload?

Answer 4

thiazide, loop diuretic, aldosterone antagonist

Question 5

drug therapy for sympathetic overactivity?

Answer 5

beta blocker –> use to counteract reflex tachycardia from vasodilators or in heart failure

Question 6

drug therapy for increased vascular resistance?

Answer 6

ACEi or ARB

Question 7

drug therapy smooth-muscle contraction?

Answer 7

dihydropyridine CCB, beta blocker, hydralazine

Question 8

DOC for recurrent stroke prevention?

Answer 8

diuretic, ACE inhibitor

Question 9

DOC for chronic kidney dz?

Answer 9

ACE inhibitors, ARB

Question 10

what are the advantages of combination therapies?

Answer 10

1. better adherence

2. may cost less for pts than individual prescriptions

Question 11

what is a good initial therapy if bp is higher than 160/100?

Answer 11

ACEi / ARBs + hydrochlorothiazide