HTN Module Flashcards
True or false, African American males have enhanced renal sodium absorption which causes them to have a higher incidence of hypertension?
True. 60% of African American males have uncontrolled HTN.
Hypertension is more common in _______ (men/women/both) until age 45. Then between ages 45-65 it is more common in (men/women/both). And after age 65 it is more common in (men/women/both).
Answer:
Men higher til 45
Equal risk 45-65
Women higher risk ages 65+
Which increases with age?
a) diastolic BP
b) systolic BP
Answer: b) systolic BP
Systolic BP increases with age (especially after age 50) and correlates with increased risk of stroke.
Which is a more potent CV risk factor until age 50?
a) diastolic BP
b) systolic BP
Answer: a) diastolic BP
Diastolic BP linked to CV risk (diastolic stabilizes with age). Systolic linked to stroke and increases with age.
ACE inhibitors affect what part of the RAAS system?
a) angiotensinogen to Angiotensin I
b) Angiotensin I to Angiotensin II
c) Angiotensin II to aldosterone
d) release of renin
Answer: b) Angiotensin I to Angiotensin II is blocked with ACE-I
What is a dipper and non-dipper, and what BP differential is expected?
Dippers: BP drops 15% at night (normal)
Non-dippers: BP drops <10% (abnormal and at risk for CVD/renal disease)
How can we evaluate dippers/non-dippers?
a) home BP log
b) ABPM
c) EKG
d) Echo
Answer: b) ABPM
When is chronopharmacology useful?
a) elderly patient with orthostatic hypotension
b) male patient with impotence r/t anti-HTN meds
c) non-dippers
d) dosing diuretics for patients without regular access to the restroom
Answer: c) non-dippers
Non-dippers can be dosed in the evening to help facilitate the normal drop in BP.
Which is false regarding BP monitoring in the office:
a) take BP in both arms and use lowest arm for subsequent measurements
b) wait 30 seconds before rechecking same arm
c) patient should sit with arm at chest level for 5 minutes
d) auscultatory measurement preferred
Answer: a) take BP in both arms and use lowest arm for subsequent measurements
For a new patient: measure BP in both arms (use HIGHER arm for subsequent BP measurements)
If ABPM is used, what average readings are considered HTN:
a) 130/80
b) 130/90
c) 135/85
d) 140/80
Answer: c) 135/85
ABPM is useful for white coat HTN, episodic HTN, patients who are hypotensive while taking meds
What medication class is most effective for decreasing LVH?
a) ARBs
b) CCB
c) ACE-I
d) HCTZ
Answer: c)ACE-I
A hypertensive emergency is when the BP is _____ and what other diagnostic criteria is present?
Emergency is 180/120 with TOD & S&S (HA, neuro changes, dizziness, nausea, vomiting). Patient needs to be TRANSPORTED to emergency dept.
Hypertensive urgency is when the BP is ____ and what other diagnostic criteria?
Urgency 180/120 w/o TOD and w/o S&S. Patient’s body has usually compensated to function at this level.
Primary hypertension is due to:
No identifiable cause (95% of patients fall into this category).
Postulated causes: inappropriate retention of water and salt.
Secondary HTN is due to:
ABCDE
Apnea, Bad kidneys, Cushings/Coarctation, Drugs/diet, Endocrine
