HTN Flashcards
(52 cards)
What are the epidemiological statistics for HTN?
50% U.S. adults have HTN most common primary care dx 90% chance of HTN if >85 yrs old only 2/3 aware they have HTN only 55% ppl w/ HTN are receiving tx
an increase in systolic BP by 2 mmHg raises risk of stroke/MI death by what %?
stroke by 10%
MI by 7%
each increment of 20 mmHg in SBP or 10 mmHg in DBP doubles risk of what?
DEATH
what are 6 major outcomes of prolonged untreated HTN?
- ASCVD, CAD, MI, LVH
- CHF
- CVA/stroke
- CKD
- peripheral vascular disease, aortic dissection/aneurysm
- vision loss
what are fixed risk factors for HTN?
family hx, male, African American, age, psychosocial stress, CKD, OSA, tobacco/nicotine use, sedentary lifestyle
what are modifiable risk factors for HTN?
tobacco, DM, dyslipidemia, obesity, high sodium diet, excessive alcohol, physical inactivity
what are causes of primary/essential HTN?
no identifiable cause
genetics
sodium, obesity, DM, dyslipidemia
alcohol, smoking, lack of exercise, low potassium intake, NSAIDs, polycythemia
white coat HTN (driven by stress/anxiety)
what are secondary endocrine causes of HTN?
hyperaldosteronism, pheochromocytoma, hyperthyroidism, Cushing’s, hyperparathyroidism
what are secondary renal causes of HTN?
renal artery stenosis, polycystic kidney disease, diabetic renal disease
what is a secondary miscellaneous cause of HTN?
stress/anxiety, OSA, pregnancy, coarctation of the aorta
what are secondary medication causes of HTN?
estrogens (OC), NSAIDs, glucocorticoids, stimulants/ephedrine, alcohol, etc.
what is resistant HTN?
uncontrolled HTN despite 3 drugs (1 of which is a diuretic)
what should you evaluate if a pt has resistant HTN?
adherence, refills
white coat HTN
causes of secondary HTN
T or F: HTN is usually asymptomatic
T
What are rare symptoms that can arise from HTN?
headache, nosebleeds, palpitations, visual changes, N/V
what should you gather in the history of a pt w/ HTN?
duration of HTN prior tx intake of agents that may cause HTN family hx symptoms of secondary causes symptoms of target-organ damage risk factors dietary hx psychosocial sexual function OSA
What are important aspects of the physical exam of a HTN pt?
general appearance, fundoscopy, neck, heart, lungs, abdomen, extremities, neurologic assessment
what should be noted in fundoscopic exam of HTN pt?
hemorrhage, papilledema, cotton wool spots, arteriorlar narrowing/nicking
what should be noted on neck exam of HTN pt?
palpation and auscultation of carotids
what should be noted on heart exam of HTN pt?
size, rhythm, sounds
what should be noted on lung exam of HTN pt?
rhonchi, rales
what should be noted on neurologic exam of HTN pt?
confusion, focal weakness, visual disturbance
what position should pt be in to correctly take BP?
pt should be seated, feet on floor, back supported, no crossing legs
how to correctly take BP
have pt rest 5 min before checking support pt's arm cuff @ mid-sternal level, empty bladder center over artery release pressure @ 2 mmHg/second NO TALKING check 2 readings 3 minutes apart
