HTN Flashcards

1
Q

What is the goal of HTN therapy?

A

To lower systolic BP

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2
Q

2 definitions of HTN:

A

Equal to or Over 140 SBP
Equal to or over 90 DBP
Taking anti-HTN meds

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3
Q

What is normal BP?

A

Less than 120/80

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4
Q

What is prehypertension?

A

120-139 SBP

Or

80-89 DBP

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5
Q

What values are considered HTN? (2 stages)

A

Stage 1:
140 OR 90-99 for 18-79 yo 18-59
150-159 OR 90-99 for over 80 or 60

Stage 2: over 160 SBP
Over 100 DBP

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6
Q

Primary/essential HTN versus secondary HTN?

A

Primary: idiopathic(don’t know cause)- many lifestyle factors
Tx = managed by lifestyle/meds

Secondary: caused by medical condition.
It is reversible with Tx

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7
Q

What pathway and specific enzyme is main regulator of BP (long term) ?

A

Renin-angiotensin-aldosterone system and the angiotensin II is the protein

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8
Q

What pathway and factors are a short term change in BP?

A

(MAP) mean arterial blood pressure changed by stroke volume and heart rate.

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9
Q

What is the most important risk factor for strokes?

A

HTN

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10
Q

What is the foundational HTN Tx r/t MNT?

A

Prescribing the DASH diet.

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11
Q

What does the DASH diet emphasize?

A
8-9 F/V servings per day 
3 low-fat dairy per day
Less than 5 sweets per week
Little meat and alcohol 
Fish, poultry, nuts
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12
Q

What mineral/electrolytes does DASH focus on?

A

Lower Na
Higher Ca
Higher K
Higher Mg

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13
Q

What are 3 main outcomes of following DASH correctly?

A

Lower LDL
Lower HTN (systolic)
Lose weight

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14
Q

What is the Na recommendation for all HTN patients?

A

2000-3000mg per day

Avg American is 3000-4500 per day

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15
Q

What does DG for Americans suggest for Na? Who needs to further reduce this level and to what?

A

Less than 2300mg

1500mg for 51+yo, black, HTN, CKD, DM (50% of Americans)

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16
Q

What does the AHA recommend for Na?

A

1500mg for everyone

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17
Q

What is the AI for Na?

What is the amount of Na DASH allows?

A

1500 mg

2400mg

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18
Q

What does the ATP IV recommend for Na?

A

2400mg
1500mg is desirable
Goal- reduce intake by 1000 mg

19
Q

Food guidelines for staying in a 4-g Na diet? 2-gram Na diet?

A

Each food less than 300mg per serving

Each food less than 200mg per serving

20
Q

Values for:
Sodium/salt free foods
Low sodium foods
Light in sodium foods

A

Less than 5mg per serving

Equal or less than 140mg per serving

50% less Na than regular version

21
Q

Values for:
Very low sodium foods
Reduced or less sodium foods
No salt added foods

A

Less than 35mg per serving

At least 25% less sodium than ref version

No salt added during processing

22
Q

Ingredients that indicate higher sodium levels?

A
Baking soda or powder
Brine 
MSG 
Sodium benzoate 
Disodium phosphate
23
Q

Examples of high sodium foods:

A
Ham
Canned tuna
Canned beans 
Processed cheeses (some natural) 
Canned tomato juice or sauce 
RTE cereals
24
Q

Examples of low sodium foods:

A
Fresh meat, fish, poultry 
Dried or frozen beans 
Fruit 
Cooked cereal, rice, pasta 
Vegetables (not canned)
25
Q

Which 2 diuretics cause loss of potassium (possible increase in BP)?

A

TcDZ and Lasix (furosemides)

26
Q

High BP is correlated with ___K, ___Ca, and ___Na?

A

Low K
Low Ca
High Na

27
Q

What is the goal for everyone under 60 with HTN? How about over 60?

A

Less than 140/90.

Less than 150/90.

28
Q

What are the initial drug Tx choices?

A

CCB (blacks)

Thiazide- diuretic (blacks)

ACEI

ARB

29
Q

HTN Tx:

Diuretics
What?
2 kinda?

A

Excrete K, Na, and urine so lower BP

Furosemide and thiazide (chlorothiazide)

30
Q

HTN Tx:

ACE Inhibitors

2 names?
What?

A

“Pril”
Captopril and enalapril

Stop angio -II production so vasodilators.

31
Q

HTN Tx:

Beta blockers

3 names?
What?

A

“Olol”
Atenolol, metoprolol,propanolol

Block receptors in heart so decrease HR and decreased Q

32
Q

HTN Tx:

Calcium channel blockers

3 names?
What?

A

Nisoldipine, nifedipine, dilitiazem

Cause blood vessel relaxation and decrease constriction.

33
Q

HYN Tx:

Aldosterone antagonists

Name?
What?

A

“Actone”

Spironolactone

K sparing, increase water and Na excretion by blocking aldosterone

34
Q

HTN Tx:

Angiotensin II receptor blockers

3 names?
What?

A

ARBs= sartan

Eprosartan, telmisartan, valsartan

Stops RAAS from working. Less aldosterone, cardiac response, vasoconstriction, vasopressin. (All less)

35
Q

DASH:

Daily servings of grains?

A

7-8 oz servings per day

Slice of bread, 1/2 cup most cooked cereals

36
Q

DASH:

Daily servings of vegetables?

A

4-5 servings per day

1 cup Raw leafy greens
1/2 cooked
6oz veggie juice

37
Q

DASH:

Daily servings of fruit?

A

4-5 servings daily.

6 oz juice
1/4 cup dried
1/2 cup fresh, fr, canned

38
Q

DASH:

Daily servings of low- fat dairy?

A

2-3 servings per day

1 cup yogurt or milk
1 1/2 oz cheese

39
Q

DASH:

Servings of meat/poultry/fish

A

2 or less servings

3oz cooked meat, fish, poultry

40
Q

DASH:

Servings of nuts, seeds, dried beans per week

A

4-5 servings per week

1 1/2 oz nuts (1/3 cup)
2 Tbsp or 1/2 oz seeds
1/2 cooked beans

41
Q

DASH:

Servings of fats per day

A

2-3 fat servings per day

1 tsp soft margarine or veg oil
1 Tbsp lowfat mayo
2 Tbsp light dressing

42
Q

DASH:

Servings of sweets per week

A

5 per week

1 Tbsp sugar/jelly or jam
1/2 oz jelly beans
8oz lemonade

43
Q

Foods high in K?

A

Potato, tomato, broccoli, sweet potato, fruits, dairy, avocado