HTN Management Flashcards
What are the new blood pressure categories in the new ACC and AHA guidelines?
Normal: less than 120 and less than 80
Elevated: 120-129 and less than 80
Stage 1: 130-139 or 80-90
Stage 2: at least 140 of at least 90
What six life style modifications to make to lower BP?
Lose weight, every 2 pounds gets you 1 point on the top
Dash diet, maybe 10 points
Exercise, aerobic and resistance training, 150 minutes/wk, 5-8 points
Cut sodium to 1500 mg daily, maybe 5 points
More potassium, 4/5 points
Limit alcohol, 4 points, 2 drinks a day for men, 1 a day for women
When do we start giving meds to patients with HTN and clinical CVD? 2 scenarios.
- Secondary prevention of recurrent CVD events in patients with CVD and average SBP of 130 or higher or an average DBP of 80 or higher
- Primary prevention in adults with an estimated 10 year ASCVD risk of 10% or higher and an average SBP 130 or higher or an average DBP 80 or higher
When do we start meds for a patient without clinical CVD with HTN?
Primary prevention of CVD in adults with hx of CVD with an estimated 10 year ASCVD risk less than 10% and average SBP over 140 or higher or DBP of 90 or higher
Treatment and follow up for the follow patients:
- Normal BP
- Elevated BP
- Stage 1 without clinical CVD or less than 10% ASCVD risk
- Stage 1 with clinical CVD or greater than 10% ASCVD risk
- Stage 2 regardless of CVD or risk
- Promote lifestyle, 1 year
- Nonpharm life style mods, 3-6 months
- Nonpharm life style mods, 3-6 months
- Life style mods and meds, 1 month to see if met goal, if did 3-6 months, if not adjust therapy
- Life style mods and meds, same
3 primary agents for BP?
2 secondary?
Thiazide, ace/arbs, calcium channel blockers
Other diuretics and beta blockers
How do thiazides and loop diuretics work?
Block NACL
Block NACL K
Which thiazide is preferred and why?
What things to monitor with thiazides?
Chlorthalidone
Potassium, uric acid and calcium
