CR III - Primary Hypertension Flashcards
What is the most modifiable risk factor for heart disease?
Primary hypertension
What are the 4 types of BP patterns?
Normotensive - normal both in office and at home
Sustained hyeprtension - Hypertension in office and home
Masked hypertension - no HTN in office, HTN at home
White coat hypertension - HTN in office, no HTN at home
What are indications for ABPM?
Suspected white coat HTN HTN while on drugs HTN resistant to increasing medication Episodic HTN Autonomic dysfunction
What two things are better predictors of CVD risk than office BP monitoring/taking?
ABPM > HBPM
What are risk factors for HTN?
Age obsesity Family Hx Race (more common in blacks) Physical inactivity High Na diet Excess alcohol intake Secondary causes - meds
What tests/labs are used to diagnose HTN?
Accurate BP 12-lead EKG CXR 10-year CVD risk - do on all pts CBC, CMP History and physical
What 4 majors things should be done in a HTN physical?
Eyes Peripheral pulses Thyroid Cardiac (additional - lungs, renal, extremities, skin, neuro)
What 7 labs/tests should be ordered?
Fasting glucose CBC Urinalysis CMP and BMP Lipid profile TSH/FT4 EKG
What life-style modification should be done first? 2nd? Others?
1st - avoid smoking
2nd - reduce weight
Others: reduce Na, eat healthy, increase physical activity, limit alcohol
Most patients require at least home many meds for HTN?
2 or more
What is the BP goal of someone on meds if they are over 60? Less than 60?
> 60 - 150/90
<60 - 130/80
If someone has an elevated BP, what treatment is recommended? When should they be re-evaluated?
Non-rxn treatment
Reasses 3-6 months
If someone is in stage 1 hypertension, what should be done? Depending on those results, what should be done next?
Clinical ASCVD 10-year risk
No - non-rxn treatment
Yes - non-rxn treatment and BP lowering medication
If someone is in stage 2 hypertension, what should be done?
Non-rxn treatment and BP lowering medication
If you start someone on BP meds, when should they be re-checked?
For stage 2 - more frequent
For stage 1 - less frequent
Monthly adjustments
Once stable every 3-6 months
