HTN Flashcards
4 stages of BP and HTN
Normal: SBP<120 & DPB <80
Elevated BP: SBP 120-129 & DBP <80 «««<!!! If it’s 80 stage 1
Stage 1 HTN : 130-139 or DBP 80-89 ( 130s/80s)
SBP ≥ 140 or DBP ≥ 90 HTN stage 2
Elevated BP steps to take
Healthy lifestyle changes reassess 3-6 months
HTN stage 1 steps to take
130-139 or DP 80-89
10 year ASCVD risk assessment
If < 10% start lifestyle changes, if not at goal 3-6 months consider medication
If ≥ 10% —> lifestyle changes plus medication with monthly follow up until BP is controlled
HTN stage 2 steps to take
Life style changes and 2 different classes of medications with monthly follow up until BP is controlled
general population
Goal BP
First line medicaiton
<130 / <80
First line HTN
thiazide
Diuretics
ACE inhibitors
ARBs
CCBs
DM
BP goal
Meds
BP < 130 / <80
Start meds if BP ≥130/ 80
First line DM+HTN = ( first line: thiazide , ace ,arb, CCB)
ACE and ARB considered first in the presence of albuminuria
CKD
goal BP: < 130 / < 80
If stage 3 or stage 1 or 2 ( plus albuminuria > 300 mg /day)
- ACE or ARB
If 18-75 CKD: start with ace or arb
If ESRD use CCB or thiazide instead ( ACE and ARB. Risk increase in k+ )
SIDH
Stable ischemic heart disease
Goal BP
Meds
< 130 / < 80
Meds: BBs, ACE, ARB
If compelling indications ( previous MI, stable angina ) as first line therapy
Pregnancy with BP
Transition meds to methyldopa, nifedipine, labetalol
AVOID
ACE ARBS DRI
African American BP
If without HF, CKD, including those with DM, initial tx
thiazide type diuretic or CCB
≥ 65 years of age
SBP < 130 if nonstitutionalized ambulatory community dwelling adults older ≥ 65 years of age
Clinical judgment if high burden of comorbidity
HF goals
BP : <130 / < 80
Medications : ACE /ARBS and BB
nondihydropyridine CCB are not recommended for HTN with HFrEF
MAP mean arterial pressure
MAP = [ SBP + 2 ( DBP ) ] / 3
