General HTN

Question 1

Initial monotherapy for: Non-black

Answer 1

THZD, ACEI, ARB, or CCB

Question 2

Initial monotherapy for: Blacks

Answer 2

THZD or CCB

Question 3

Initial monotherapy for: CKD, non-black or black

Answer 3

ACEI or ARB

Question 4

Initial monotherapy for: DM, Non-black

Answer 4

ACEI or ARB

Question 5

Initial monotherapy for: DM, black

Answer 5

THZD or CCB

Question 6

Describe 4 therapeutic lifestyle measures you can tell your patient to do to help their HTN?

Answer 6

1. Dash Diet
   - limit Na and ETOH
2. Exercise
3. Wt. loss
4. K+ supplementation (preferably through diet) - as long as no CKD / K+ retaining meds

Question 7

Why is ACEI/ARB + Thiazide a “preferred combo”?

Answer 7

• ACEI/ARB improves diuretic-induced RAAS activation
• additive BP reduction
• outcomes data for reduction of CVA, HF, mortality, DM complications

Question 8

Why is ACEI/ARB + DHP-CCB a “preferred combo”?

Answer 8

• ACEI/ARB improves CCB-induced edema and sympathetic stimulation
• additive BP reduction
• DHP-CCB outcome data primarily with Amlodipine

Question 9

American Society of HTN Guideline:

Nonblack younger than 60yo

Answer 9

ACEI or ARB

Question 10

American Society of HTN Guideline:

Nonblack older than 60yo

Answer 10

CCB, Thiazide, ACEI or ARB

Question 11

American Society of HTN Guideline:

Pt w/CKD

Answer 11

ACE or ARB

Question 12

American Society of HTN Guideline:

Pt w/CAD

Answer 12

Beta blocker and ARB or ACEI

Question 13

American Society of HTN Guideline:

Pt w/DM

Answer 13

ARB or ACEI

CCB or thiazide w/black pt

Question 14

American Society of HTN Guideline:

Pt w/HF

Answer 14

ARB or ACEI and beta blocker and spironolactone

Question 15

American Society of HTN Guideline:

Pt w/h/o stroke

Answer 15

ACEI or ARB

Question 16

Be able to recognize medications that induce HTN:

Answer 16

1. OCPs
2. Stimulants
3. Transplant meds
4. EPO
5. Corticosteroids
6. NSAIDs
7. Sympathomimetics
8. Neuropsychiatrics