Exam 4 - HTN - Organized Flashcards
what is normal classification of HTN?
SBP < 120
DBP < 80
s2
what are clinical consequences of chronically elevated BP?
s3
ischemic heart disease, stroke, renal failure, retinopathy, PVD, and overall mortality
s3
What is the range for :
isolated systolic HTN?
isolated diastolic HTN?
combined sys and diastolic HTN?
s3
- isolated systolic HTN - SBP >130 mm Hg and DBP <80 mm Hg
- isolated diastolic HTN - SBP <130 mm Hg with DBP >80 mm Hg
- combined systolic and diastolic HTN - SBP >130 mm Hg and DBP >80 mm Hg
s3
what are (3) genetic and lifestyle risk factors for HTN?
s4
obesity, alcoholism and tobacco
s4
what is also a risk factor for cardiovascular morbitity (in addition to SBP and DBP elevation)?
and why?
s3
widened pulse pressure because it correlates w/vascular remodeling and “stiffness”
s3
what herbals elevate BP?
s4
ephedra, ginseng, ma huang
s4
What are contributing factors for primary HTN?
s4
- SNS activity
- dysregulation of the RAAS
- deficiency in endogenous vasodilators
Actual cause of primary HTN is unclear!
s4
What are (5) common causes of secondary HTN in middle-aged adults?
s4
hyperaldosteronism, thyroid dysfunction, OSA, Cushings, and pheochromocytoma
s4
What are 2 causes for children w/ secondary HTN?
s4
renal parenchymal disease or coarctation of the aorta
s4
what is an Anti-infective that elevates BP?
s6
Ketoconazole
s6
what are the 2 anti-inflammatory classes that elevate BP?
s6
NSAIDs and COX-2 inhibitors (-coxib’s)
s6
what 2 illicit drugs elevate BP?
amphetamines and cocaine
s6
list 3 immunosuppresive agents that may elevate BP
cyclosporine, sirolimus, tacrolimus
s6
what 2 steroids may elevate BP?
methylprednisolone and prednisone
s6
what 2 random sympathomimetics elevate BP?
s6
decongestant and diet pills
s6
list hormones and psych meds that may elevate BP
- hormones: oral contraceptives (estrogen and progesterone), androgens
- psych: buspar, carbamazepine, lithium, clozapine, MAO-Is, SSRIs, TCAs
s6
Per ACC/AHA guidelines, there is a moderate evidence to support antihypertensive therapy with which medications in those w/ CKD to improve kidney outcomes?
ACE-I or ARB
S7
what are 3 causes of secondary HTN in older adults (>65 yo)?
s7
atherosclerotic renal artery stenosis, renal failure, hypothyroidism
s7
What does chronic HTN lead to? (vascularly..)
remodeling of small & large arteries, endothelial dysfunction, and potentially irreversible end-organ damage
s8
What plays a major role in ischemic heart dz, LVH, CHF, CVA, PAD, aortic aneurysm, and nephropathy?
Disseminated vasculopathy
s8
what 2 ultrasound measurements can provide an early dx of vasculopathy?
- common carotid intimal to medial thickness
- arterial pulse-wave velocity
what tests can track progression of LV hypertrophy?
Echocardiographic and electrocardiographic indexes
s8
what imaging can be used to identify cerebrovascular damage?
MRI - to follow microangiopathic changes
s8
What are the 4 examples of end-organ damage due to HTN?
Vasculopathy
Cerebrovascular damage
Heart disease
Nephropathy
S9