HTN Flashcards

1
Q

HTN prevalence

A

> 100 million people
African Americans > non-Hispanic Whites
Women > men, older than 60 years
Leading risk factor for morbidity and mortality in ppl

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2
Q

Systolic htn

A

Sustained systolic BP > 130 mm Hg

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3
Q

Diastolic htn

A

Sustained diastolic BP > 80 mm Hg

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4
Q

Isolated systolic hypertension

A

Systolic > 130 mm Hg and diastolic < 80 mm Hg

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5
Q

Isolated diastolic hypertension

A

Systolic < 130 mm Hg with diastolic > 80 mm Hg

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6
Q

Combined systolic and diastolichypertension

A

Systolic > 130 mm Hg and diastolic > 80 mm Hg

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7
Q

Elevated htn

A

120-129
<80

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8
Q

Stage 1 htn

A

130-139
80-89

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9
Q

stage 2 htn

A

> 140
90

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10
Q

Primary HTN (Essential) etiology

A

Specific etiology unclear

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11
Q

Primary HTN (Essential) contributing factors

A

SNS activity
Dysregulation of the renin-angiotensin-aldosterone system
Deficient production of endogenous vasodilators
Oxidative stress -> stiff vessels

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12
Q

RAAS controls…..

A

Extracellular fluid volume-> aldo release for na reabsprtion
Peripheral resistance-> maintain
Blood pressure

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13
Q

Dysregulated renin release leads to….

A

Elevated renin levels
Angiotensin II overproduction
Increased aldosterone
HTN

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14
Q

Angiotensin I cleaved into Angiotensin II by …..

A

chymase (human mast cell protease = bypass angiotensin cleaves to)

Acei don’t work on chymase = cant take acei

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15
Q

Angiotensin produced in…..

A

Production of angiotensin II in fat, blood vessels, heart, adrenals, and brain

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16
Q

Major regulators of vascular tone

A

Nitric oxide and endothelin
No – vasodilation
Endothelin = vasodilation or constriction

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17
Q

Atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), C-type natriuretic peptide (CNP), and urodilatin….

A

Blunts RAAS…

18
Q

Oxidative stress causes

A

Impaired endothelial function
Disruption of NP release or receptor response-> HTN

19
Q

Secondary htn prevalence

A

Secondary HTN
5% of population
Correctable cause
Age-dependent or drug-induced
Stop drug = htn goes away

20
Q

herbals that cause htn

A

ephedra, ginseng, ma huang

21
Q

% of children with htn w/ an underlying cause

A

birth -12yr = 70-85, most common etiologies = renal parenchymal disease

22
Q

Resistant HTN

A

Above goal BP despite ≥3 antihypertensive drugs of different classes

23
Q

Controlled resistant HTN

A

Need for ≥4 drugs to achieve control

24
Q

Refractory HTN

A

Uncontrolled BP on ≥5 drugs
Drug intolerance or pseudo-resistant HTN (0.5% of pop)

25
Lifestyle modifications for htn
Weight reduction Moderation of alcohol intake Increased aerobic exercise Smoking cessation Dietary potassium and calcium intake Salt restriction
26
Non-black hypertensive population (w/ or w/o DM) medications
ACE inhibitors, ARBs, CCBs, or thiazide-type diuretics
27
ACC/AHA Guidelines for bp
Multiple BP readings for diagnosis Nonpharmacologic interventions Pt w/ IHD, cerebrovascular disease, CKD, or with an elevated risk of atherosclerotic CV disease treat SBP > 130 mm Hg and DBP > 80 mm Hg
28
Black hypertensive population w/o HF nor CKD (w/ or w/o DM) medications
Initiating treatment w/ CCBs or thiazide-type diuretic
29
Chronic kidney disease htn medications
ACE inhibitor or ARB
30
First-line antihypertensive therapy
Diuretics, CCBs, ACE inhibitors, and ARBs
31
Beta-blockers given for ......
CAD or tachydysrhythmias Multi-drug therapy in resistant HTN
32
Interventional tx for secondary htn
Correction of renal artery stenosis Direct arterial repair Adrenalectomy
33
med tx for secondary htn
ACE-Is or in combination with diuretics
34
Urgent/emergent htn crises
Urgent or emergent Progressive organ damage
35
Central nervous system injury  from htn emergencies
Hypertensive encephalopathy, intracerebral hemorrhage, subarachnoid hemorrhage, and acute stroke
36
PIH
Systolic pressure > 160 mm Hg and/or diastolic pressure > 110 mm Hg require immediate intervention can have Encephalopathy-> end organ dysfunction
37
First-line drug for peripartum hypertension
labetalol
38
Aortic dissection with htn crises treatment
β-blocker (esmolol, labetalol) plus arteriolar dilator
39
Medication for Rapid arterial dilation and BP reduction
sodium nitroprusside infusion
40
Pressure to cancel surgery
> 180 mmhg
41
Htn medications to DC prior to surgery
High-dose ARBs and ACE inhibitors
42
BP Medications to DC prior to sx
High-dose ARBs and ACE inhibitors--24 hrs