Hypertension Flashcards
what is blood pressure?
fluid pushed into vessels; force against the arterial walls
what is hypertension?
- loss of regulatory control
- increase arterial resistance
what is high blood pressure?
- Blood pressure normally rises and falls
- arteries stretch when blood cirulates
More pressure = more stretch
Pressure in the arteries when the heart contracts
systole
- pressure when the heart relaxes
- the ventricular cavity is refilling with blood
diastole
What features should provoke screening for secondary hypertension?
- resistant HTN
- abrupt onset
- age < 30
- disproportionate target organ damage
- diastolic HTN > 65 years old
- accelerated/Malignant
- decrease potassium
when assessing for target organ damage, what should be considered?
- Left ventricular hypertrophy
- coronary artery disease (myocardial infarction, percutaneous intervention, s/p CABG)
- Cerebrovascular disease
- peripheral arterial disease
- chronic kidney disease
- retinopathy
- systolic and/or diastolic heart failure
what are signs/symptoms of hypertension?
- None– “silent killer” (often there are no warning signs/symptoms)
- headache
- vision changes
- nausea, vomiting
- dizziness/lightheadedness
- chest pain
- numbness/tingling
Systolic < 120mmhg and < 80mmhg
Normal
systolic 120-129 and < 80mmHg
elevated blood pressure
systolic 130-139 or diastolic 80-89
Stage 1 hypertension
Systolic > 140 or > 90mmhg
Stage 2 hypertension
what are target risk factors for hypertension?
- family history
- tobacco use
- genetic disorders
- environmental factors
- obstructive sleep apnea
- obesity & sedentary lifestyle
- psychosocial stressors
- dietary patterns: sodium, alcohol
what are the big 4 of hypertension?
- obesity
- diet
- substance use
- exercise
- Low in saturated fat, cholesterol
- fruits, vegetables, and low-fat dairy products
- reduce red meat, sweets, and sugar containing beverages
- decrease blood pressure in 2 weeks
Dash Diet
when should meds be started for hypertension?
- Stage 1:
1. Prior CVD (heart attack, stroke, heart failure, peripheral arterial disease) or
2. clinical ASCVD risk > 10% - Stage 2 (>140/90mmHg): everyone
what is considered smart prescribing for patients over 65?
- “start low, go slow”
- start with 1 antihypertensive medication (even in stage 2 hypertension, align with co-morbid condition
