HTN- CV risk assessment and health promotion

Question 1

Why should global CV risk be assessed in HTN patients?

3

Answer 1

• accurately predict CV risk
• engage in conversations about risk
• use antihypertensive therapy more efficiently

Question 2

What type of risk calculation should be avoided when making treatment decisions?

Answer 2

absolute levels of risk

lack of canadian data to utilize absolute levels of risk

Question 3

What does informing patients of global risk do?

Answer 3

increase effectiveness of risk factor modification

Question 4

What can you do to describe comparative risk to inform patients of their risk status?

Answer 4

use analogies like heart age

Question 5

Is ASA a routine recommendation for primary prevention in people with HTN

Answer 5

no

Question 6

When is statin therapy recommended as prevention therapy

2

Answer 6

pts with 3+ CV risk factors
pts with established atherosclerotic disease

Question 7

What should be offered to smokers who want to stop smoking

2

Answer 7

advice
pharamcotherapy like bupropion

Question 8

What is the recommendation for exercise for people with and without HTN

Answer 8

30-60 mins mod cardio exercise 4-7 days a week

higher intensity isnt more effective

Question 9

What waist circumference should be maintained to prevent HTN and for HTN patients?

Answer 9

men <102cm
women <88cm

Question 10

What is the significance of waist measurement to look at visceral fat stores in a patient?

Answer 10

visceral fat is metablically active and releases substances that lead to:
insulin resistance
dyslipidemia
inflammation

these contribute to development of HTN and CV issues

Question 11

What is the max alcohol consumption to prevent HTN and for HTN patients

Answer 11

max 2 drinks/day

in pts who drink 2/day decreasing further will imrpove BP

Question 12

What diet is recommended for HTN patients and to avoid developing HTN

Answer 12

DASH

fruit, veg, low fat dairy, whole grains, plant protein

Question 13

To prevent HTN and reduce BP in HTN pts what should sodium intake be limited to?

Answer 13

2000mg

Question 14

What are the supplementation recommendations for Ca, Mg, and K

Answer 14

Ca and Mg- no supplementation recommended
K - increase K to decrease BP

K- if not at risk of hyperkalemia

Question 15

Which 4 patients are at risk of hyperkalemia

Answer 15

• pts on renin-angiotensin-aldosterone inhibitors
• pts on other drugs that make K increase (sulfa/trim)
• pts with high baseline K (>4.5)

Question 16

What types of cog behav interventions are more likely to be sucessful in lowering BP

Answer 16

ones that utilize relaxation