HTN Flashcards
How is HTN defined in adults 18 years old and older?
SBP > 140 mmHg and DBP >90 mmHg based on the average of two or more properly measured seated BP reading on two or more office visits
What is essential HTN?
HTN without any identifiable cause
What are some causes of secondary HTN?
Primary aldosteronism
Cushing’s syndrome
Phenochromocytoma
Coarction of aorta
Renal Artery Stenosis
Renal disease
Certain Medications
What medications can cause HTN?
Oral Contraceptives (OCPs)
NSAIDs
Steroids
Amphetamines
MAOIs
Ergots
Diet pills
Decongestants
Toxins
Licorice
What is Prehypertension?
SBP 120 - 139 mm Hg/DBP 80 - 89 mm Hg
What is Stage 1 HTN?
SBP 140 - 159 mm Hg/DBP 90 - 99 mm Hg
What is Stage 2 HTN?
SBP ≥160 mm Hg/DBP ≥100 mm Hg
What ethinicity and gender is HTN more common in?
African American Males
What are some reversible causes of HTN?
obesity
obstructive sleep apnea
Renovascular disease
Chronic steroid therapy
Cushing’s syndrome
Primary hyperaldosteronism
Pheochromocytoma
Coarctation of the aorta
Thyroid disease, parathyroid disease
Excess alcohol intake.
When is malignant HTN diagnosed?
When a patient presents with severely elevated BP in the range of ≥180 mm Hg/110 mmHg and evidence of acute target organ damage.
What evidene indicates target organ damage?
●Papilledema, hemorrhages, or exudates on funduscopicexamination
●Change in mental status or neurologic deficits on
physical examination
●ECG consistent with myocardial ischemia or infarction
●Chest x-ray film showing heart failure or aortic
dissection
●Renal dysfunction evidenced by hematuria, proteinuriaand elevated serum creatinine.
What diagnostic tests are done for HTN and what do they reveal?
Urinalysis - Proteinuria
BUN - Increased
CBC - May show anemia
Potassium - Increased or decreased
Blood glucose - May be increased
Triglycerides, HDL, LDL - Increased
12-lead ECG - May show target organ damage
What lifestyle modifications are necessary to manage HTN?
Weight reduction
DASH (Dietary Approaches to Stop Hypertension)
Dietary sodium reduction
Physical activity
Moderation of alcohol
Stop smoking
What does the DASH diet consist of?
Consuming a diet rich in fruits, vegetables, and low-fat dairy products with a reduced content of saturated and total fat
Older adults are more likely to have _ _ HTN
Isolated sytolic (HTN)
Why should diuretics be used in a lower dose with older adults when prescribed for HTN?
Because of lower circulatory volume
When should you f/u patients being treated with lifestyle modifications only?
3-6 months to see efficacy and adherence to the program
When should you f/u after initiating antihypertensive drug therapy?
2-3 weeks for a blood pressure check or 1-2 weeks for electrolyte &/or s/e check
- What does ACEIs stand for?
- What do they end with?
- Angiotensin Converting Enzyme Inhibitors
- pril
What comorbid conditions would prompt you to order ACEIs and why?
- HF & MI - b/c it can limit cardiac remodeling
- Renal insufficiecy & DM - b/c it may assist in preserving or enhancing renal function
What are the two contraindictions for ACEIs?
- Pregnancy
- Renal artery stenosis
What are some s/es for ACEIs when given with aldosterone?
Orthostatic hypotension
Sinus tachycardia
Fatigue
Dizziness
Syncope
Headache
What are some common s/es of ACEIs?
Dry cough
Angioedema (facial edema)
Hyperkalemia
What does ARB stand for and what do they end with?
Angiotensin Receptor Blockers
- sartan
