HTN Flashcards
What is the goal of HTN therapy?
To lower systolic BP
2 definitions of HTN:
Equal to or Over 140 SBP
Equal to or over 90 DBP
Taking anti-HTN meds
What is normal BP?
Less than 120/80
What is prehypertension?
120-139 SBP
Or
80-89 DBP
What values are considered HTN? (2 stages)
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
Primary/essential HTN versus secondary HTN?
Primary: idiopathic(don’t know cause)- many lifestyle factors
Tx = managed by lifestyle/meds
Secondary: caused by medical condition.
It is reversible with Tx
What pathway and specific enzyme is main regulator of BP (long term) ?
Renin-angiotensin-aldosterone system and the angiotensin II is the protein
What pathway and factors are a short term change in BP?
(MAP) mean arterial blood pressure changed by stroke volume and heart rate.
What is the most important risk factor for strokes?
HTN
What is the foundational HTN Tx r/t MNT?
Prescribing the DASH diet.
What does the DASH diet emphasize?
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
What mineral/electrolytes does DASH focus on?
Lower Na
Higher Ca
Higher K
Higher Mg
What are 3 main outcomes of following DASH correctly?
Lower LDL
Lower HTN (systolic)
Lose weight
What is the Na recommendation for all HTN patients?
2000-3000mg per day
Avg American is 3000-4500 per day
What does DG for Americans suggest for Na? Who needs to further reduce this level and to what?
Less than 2300mg
1500mg for 51+yo, black, HTN, CKD, DM (50% of Americans)
What does the AHA recommend for Na?
1500mg for everyone
What is the AI for Na?
What is the amount of Na DASH allows?
1500 mg
2400mg
What does the ATP IV recommend for Na?
2400mg
1500mg is desirable
Goal- reduce intake by 1000 mg
Food guidelines for staying in a 4-g Na diet? 2-gram Na diet?
Each food less than 300mg per serving
Each food less than 200mg per serving
Values for:
Sodium/salt free foods
Low sodium foods
Light in sodium foods
Less than 5mg per serving
Equal or less than 140mg per serving
50% less Na than regular version
Values for:
Very low sodium foods
Reduced or less sodium foods
No salt added foods
Less than 35mg per serving
At least 25% less sodium than ref version
No salt added during processing
Ingredients that indicate higher sodium levels?
Baking soda or powder Brine MSG Sodium benzoate Disodium phosphate
Examples of high sodium foods:
Ham Canned tuna Canned beans Processed cheeses (some natural) Canned tomato juice or sauce RTE cereals
Examples of low sodium foods:
Fresh meat, fish, poultry Dried or frozen beans Fruit Cooked cereal, rice, pasta Vegetables (not canned)
Which 2 diuretics cause loss of potassium (possible increase in BP)?
TcDZ and Lasix (furosemides)
High BP is correlated with ___K, ___Ca, and ___Na?
Low K
Low Ca
High Na
What is the goal for everyone under 60 with HTN? How about over 60?
Less than 140/90.
Less than 150/90.
What are the initial drug Tx choices?
CCB (blacks)
Thiazide- diuretic (blacks)
ACEI
ARB
HTN Tx:
Diuretics
What?
2 kinda?
Excrete K, Na, and urine so lower BP
Furosemide and thiazide (chlorothiazide)
HTN Tx:
ACE Inhibitors
2 names?
What?
“Pril”
Captopril and enalapril
Stop angio -II production so vasodilators.
HTN Tx:
Beta blockers
3 names?
What?
“Olol”
Atenolol, metoprolol,propanolol
Block receptors in heart so decrease HR and decreased Q
HTN Tx:
Calcium channel blockers
3 names?
What?
Nisoldipine, nifedipine, dilitiazem
Cause blood vessel relaxation and decrease constriction.
HYN Tx:
Aldosterone antagonists
Name?
What?
“Actone”
Spironolactone
K sparing, increase water and Na excretion by blocking aldosterone
HTN Tx:
Angiotensin II receptor blockers
3 names?
What?
ARBs= sartan
Eprosartan, telmisartan, valsartan
Stops RAAS from working. Less aldosterone, cardiac response, vasoconstriction, vasopressin. (All less)
DASH:
Daily servings of grains?
7-8 oz servings per day
Slice of bread, 1/2 cup most cooked cereals
DASH:
Daily servings of vegetables?
4-5 servings per day
1 cup Raw leafy greens
1/2 cooked
6oz veggie juice
DASH:
Daily servings of fruit?
4-5 servings daily.
6 oz juice
1/4 cup dried
1/2 cup fresh, fr, canned
DASH:
Daily servings of low- fat dairy?
2-3 servings per day
1 cup yogurt or milk
1 1/2 oz cheese
DASH:
Servings of meat/poultry/fish
2 or less servings
3oz cooked meat, fish, poultry
DASH:
Servings of nuts, seeds, dried beans per week
4-5 servings per week
1 1/2 oz nuts (1/3 cup)
2 Tbsp or 1/2 oz seeds
1/2 cooked beans
DASH:
Servings of fats per day
2-3 fat servings per day
1 tsp soft margarine or veg oil
1 Tbsp lowfat mayo
2 Tbsp light dressing
DASH:
Servings of sweets per week
5 per week
1 Tbsp sugar/jelly or jam
1/2 oz jelly beans
8oz lemonade
Foods high in K?
Potato, tomato, broccoli, sweet potato, fruits, dairy, avocado
