Hypertension Flashcards
(PPP 60)
2017 ACC/AHA Guidelines:
normal bp =
SBP <120 and DBP <80
(PPP 60)
2017 ACC/AHA Guidelines:
elevated bp =
SBP 120-129 and DBP <80
(PPP 60)
2017 ACC/AHA Guidelines:
Stage I HTN =
SBP 130 - 139 or DBP 80 - 89
(PPP 60)
2017 ACC/AHA Guidelines:
Stage II HTN =
SBP >= 140 or DBP >= 90
(PPP 60)
definition of HTN
“SBP of 130 mmHg or more and/or DBP 80 mmHg ore more”
(PPP 60)
part 2 of the definition of HTN, the conditions of the definition:
…“the elevations must be at least 2 different readings on at least 2 different visits”
(PPP 60)
what is the MC cause of primary (essential) HTN?
idiopathic etiology (95% of the time)
(PPP 60)
what is secondary HTN?
it is HTN due to an underlying, often correctable, cause
(PPP 60)
what is the MC cause of secondary HTN?
renovascular, i.e. renal artery stenosis, is the MC cause of secondary HTN
(PPP 60)
what percent of HTN is secondary HTN?
5%
(PPP 60)
0.5% of secondary HTN is caused by….
ENDOCRINE stuff.
maybe Cushing syndrome or hyperaldosteronism
(PPP 60)
four common complications of HTN
C/V
neurologic
nephropathy
optic
(PPP 60)
second MC cause of end stage renal disease in the US
HTN nephropathy
second only to DM
(PPP 60)
initial mgmt of choice of newly diagnosed hypertensive
lifestyle mgmt
- wt loss
- DASH diet
- exercise
- reduce ETOH
(PPP 60)
if lifestyle management fails to control HTN, what is second line?
medical management
(PPP 60)
bp target for hypertensive adults <60 yrs
bp target for hypertensive adults >60 yrs
<140/90 for <60 yrs
<150/90 for >60 yrs
(PPP 61)
four classes of initial hypertensive therapies for uncomplicated HTN (non AA)
thiazide-type diuretics
ACE inhibitors
Angiotensin II receptor blockers
CCB
(PPP 61)
optimum anti-hypertensive therapy for pts with angina
BB
CCB
(PPP 61)
optimum anti-hypertensive therapy for pts who are post MI
ACE-I
BB
(PPP 61)
optimum anti-hypertensive therapies for pts who have concomitant systolic heart failure
ACE-I
ARB
BB
diuretics
(PPP 61)
anti-hypertensive therapy for pts who also have DM or CKD
ACE-I
ARB
(PPP 61)
anti-hypertensive therapy for pts who also have BPH
alpha 1 blockers
(PPP 61)
anti-hypertensive therapy for pts who are African American
thiazides
CCB
(PPP 61)
anti-hypertensive therapy for pts who also have gout
CCB
“losartan is the only ARB that doesn’t cause hyperuricemia”
(PPP 61)
anti-hypertensive therapy for pts who also have AFib or AFlutter
BB
CCB
(PPP 62)
MOA of diuretics
prevent kidney Na+/water reabsorption at DISTAL DILUTING TUBULE –> reduces blood volume
(PPP 62)
two primary pharmaceutical diuretics
HCTZ
chlorthalidone
(PPP 62)
list 5 adverse effects of diuretic antihypertensives
hypOnatremia
hypOkalemia
hypERuricemia (caution in pts w/ gout)
hypERglycemia (caution in pts with DM)
hypERcalcemia
(PPP 63)
list four CCB antihypertensives
nifedipine & amlodipine (diydropyridines)
verapamil & diltiazem (non-dihydropyridines)
(PPP 63)
MOA of dihydropyridines
potent vasodilators (little or no effect on cardiac contractility or conduction)
(PPP 63)
MOA of non-dihydropyridines
AFFECT CARDIAC CONTRACTILITY & CONDUCTION
- as well as potent vasodilators,
- reduces vascular permeability
(PPP 63)
AE’s of CCBs
HA DIZZINESS LIGHTHEADEDNESS FLUSHING PERIPHERAL EDEMA CONSTIPATION WITH VERAPAMIL
(PPP 63)
contraindications for CCBs
2nd/3rd degree heart blok
pts taking BB
CHF
