Hypertension Flashcards
Define stage 1 and stage 2 hypertension.
Stage 1 = SBP 130-139 and DBP = 80-89
Stage 2= SBP >139 and DBP >89
What is the equation for blood pressure?
Cardiac output x systemic vascular resistance
Risk factors for primary (essential) hypertension?
Advancing age, obesity, family history, race (black), reduced nephron number, high sodium diet, excessive alcohol consumption, and physical inactivity.
What are some causes of secondary hypertension?
Medications, illicit drug use, primary kidney disease, primary aldosteronism, renovascular htn, obstructive sleep apnea, pheochromocytoma, Cushing’s syndrome, coarctation of the aorta, endocrine disorders.
List some medications associated with secondary htn.
Oral contraceptives (particularly high estrogen), Chronic NSAID use, Antidepressants (TCAs), corticosteroids, decongestants, weight loss medications, cyclosporine or tacrolimus, stimulants, atypical antipsychotis, angiogenesis inhibitors, tyrosine kinase inhibitors,
Primary aldosteronism should be suspected with what triad of symptoms?
HTN, hypokalemia, and metabolic alkalosis
What labs should be preformed in patients with newly diagnosed HTN?
Electrolytes, fasting glucose, urinalysis, CBC, TSH, Lipid profile, ECG, 10 year ASCVD risk.
When should you do testing for secondary HTN?
Hypertension under unusual circumstances, such as new onset at young age, or pt with previously normal BP. Abrupt onset, or significant elevation in previously controled patient.
Treatment for ALL patients with hypertension?
Lifestyle modification
List some lifestyle modifications for HTN management.
Dietary salt restriction, potassium suplementation, weight loss, DASH diet (high in veg, fruits, low fat dairy, whole grains, poultry, fish, and nuts. low in sweets, and red meats), exercise, limited alcohol intake,
Patients with what comorbidities really need to be treated for HTN?
Established cardiovascular disease, DMII, CKD, age >65, >10% 10 year ASCVD risk.
Name 4 classes of drugs for initial therapy for HTN?
Thiazide or thiazide like dieuretics, long acting CCBs (most often a dihydropyridine such as amlodipine), ACEIs, ARBs
When should a thiazide or thiazide like diuretic be chosen as initial monotherapy?
Black patients
When should an ACEI or ARB be selected for initial monotherapy?
Patients with diabetic neuropathy or nondiabetic chronic kidney disease
When are beta blockers recommended in HTN treatment?
Only when there is a specific indication for their use, such as ischemic heart disease or HFrEF
