Clinical Reasoning-Hypertension Flashcards
How does prehypertension affect your risk of having a stroke or coronary event?
It doubles it.
When measuring someone’s systolic and diastolic blood pressures, what are the best values to consider in elderly? In youth?
In the elderly, increases in systolic and pulse pressures are the best predictors. In youth increases in diastolic pressure is the best predictor of CHD events.
What is hypertension defined as?
A sustained systolic BP > 140 OR a diastolic BP > 90.
What complications arise in other organs as a result of hypertension?
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How does hypertension actually increase atherosclerotic plaques even if you are watching your cholesterol?
Shear stress = endothelial injury and thrombus formation.
How does hypertension ultimately lead to heart failure or MI?
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A patient comes to the ED with a blood pressure of 190/120. Why is this a hypertensive emergency?
Retinal hemorrhage, acute kidney damage, acute heart failure, MI and intracerebral hemorrhage.
What are some of the hypothesis explaining essential hypertension?
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What secondary causes of hypertension have been identified?
Sleep apnea, drugs, kidney disease, obesity, Cushing’s, primary aldosteronism, pheochromocytoma and aortic coarctation.
How does renal artery stenosis cause hypertension?
Glomerulus senses decreased perfusion and releases increasing amounts of renin.
What is resistant hypertension?
Uncontrolled hypertension despite treatment with 3 separate medications.
