Hypertension

Question 1

Primary hypertension (90-95%)

Answer 1

Unknown cause, environmental (high salt intake, obesity, sedentary lifestyle) and genetic factors are involved

Question 2

Secondary hypertension (5-10%)

Answer 2

Cause can be identified and sometimes treated, can be from CKD, renal artery stenosis, etc.

Question 3

Highest prevalence of HTN among races

Answer 3

African Americans

Question 4

How many HTN patients are at their controlled goal

Answer 4

29%

Question 4

4 Core health behaviors

Answer 4

Smoking, physical activity, diet, weight

Question 4

Tests for HTN

Answer 4

Electrolytes, fasting glucose, serum creatine and BUN, lipids, hematocrit, urine sample

Question 4

Typical HTN treatment goal

Answer 4

< 130/80 mmHg

Question 5

Drugs that induce HTN

Answer 5

Steroids, NSAIDs, caffeine/nicotine, oral contraceptive hormones, illicit drugs, sympathomimetics, inadequate diuretic therapy

Question 5

Class of Recommendation (COR)

Answer 5

I - strong
IIa - moderate
IIb - weak
III no benefit
III harm

Question 5

Quality of Evidence (QOE)

Answer 5

A - high quality
B-R - moderate quality, randomized
B-NR - moderate qulaity, non-randomized
C-LD - limited data
C-EO - expert opinion

Question 6

Normal BP

Answer 6

<120/<80 mmHg

Question 7

Elevated BP

Answer 7

120-129/<80 mmHg

Question 8

HTN Stage 1

Answer 8

130-139 SBP or 80-89 DBP

Question 9

HTN Stage 2

Answer 9

> 140 SBP or > 90 DBP

Question 10

BP Follow up

Answer 10

Normal - 1 year
Elevated - 3-6 months (recommend nonpharm therapy)
Stage 1 - 3-6 monts if nonpharm therapy, 1 month if pharm therapy (depends on estimated 10 year risk of CVD is higher than 10%)
Stage 2 - 1 month with nonpharm and pharm therapy (can start on 2 drugs)

Question 11

Nonpharm therapy for decreasing HTN

Answer 11

Weight loss
DASH diet
Decrease sodium
Increase potassium
Physical activity
Moderate alcohol intake