Hypertension Flashcards
marker vascular inflammation
CRP
difference in vascular remodelling between small and large arteries
small arteries undergo inward eutrophic remodelling leading to increased peripheral resistance
hypertrophic remodelling of large arteries result in
increase in vascular stiffness
inward eutrophic remodelling is mediated by
RAAS
hypertrophic remodelling is mediated by
sympathetic discharge
site of AT2 receptors
adrenal medulla,uterus,ovary
prohypertensive adipokines
leptin, angiotensinogen, resistin, retinol binding protein (RBP4), plasminogen activator inhibitor-1 (PAI-1), tumor necrosis factor (TNFα), fatty acids, sex steroids, and growth factors
antihypertensive adipokine
adiponectin
In which condition elevated plasma and urine catecholamines mimic pheochromocytoma
OSA
Effect of sex hormones on BP
estrogen effects unclear
exogenous estrogen increases
testosterone increases BP
avereage BP rise caused by each cigarrette
7/4
protective factor in coffee
polyphenols
magnesium deficiency is common in
diabetics
nutrient supplementation helpful in hypertension
potassium-magnesium-citrate
Falsely positive aldosterone to renin ratios used for screening for primary aldosteronism.
luteal phase of menstrual cycle
SMOKING induced rise in BP is not attenuated by which anti hypertensive
non selective beta blockers
effect of sibutramine on BP
decreases central sympathetic outflow but increases peripheral sympathetic discharge
benefits of moderate sodium reduction
Decreased incidence of osteoporosis cataract stomach cancer stroke asthma
Sodium restriction enhances the antihypertensive efficacy of all drugs except
calcium channel blockers
Antihypertensive that affects exercise capacity
beta blockers
Sexual activity is equivalent to stage ________ of bruce protocol
2 for men and 1 for women
one portion of alcohol is equivalent to
12g of ethanol
recommended alcohol intake
one portion for women
two portions for men
antihypertensive effect of beetroot juice is because of
nitrate
vegetable that can lower BP
garlic
sedative that can lower BP
melatonin 2.5mg at bedtime
Nutrient that can reduce BP
high folate intake
Long acting and short acting antihypertensives in each class
Metoprolol Vs atenolol(s)
trandolopril Vs enlapril
amlodipine Vs felodipine
vasodilating beta blocker
nebivolol
antihypertensives used if Cr>1.5
loops
metolazone
Which is better?
chlorthalidone or hydrochlorthiazide
chlorthalidone
Advantages of indapamide
no effect on lipid profile
regression of LVH
decreses microalbuminuria
Pts who respond better to thiazides
elders,probably because of renin hyporesponsiveness
antihypertensives that provide better protection against strokes
thiazides
The need for a diuretic is lessened with use of which antihypertensives
ARB
ACEI
CCB
Time required for full anti hypertensive effects of low dose thiazides
4 weeks
causes of resistance to diuretics
excessive Na intake
renal insufficiency
NSAID
repletion of diuretic induced hypokalemia..drug used and why?
Kcl
replacement of intracellular K+
correction of alkalosis
role of pot citrate and bicarbonate in diuretic induced hypokalemia
osteoporosis
renal stones
Treatment of diuretic induced hyperuricemia
probenecid
losartan
Insulin resistance due to thiazides closely correlates with
hypokalemia
Why loops are given as 1-1-0
To act at time of salt intake
to avoid nocturia
Bumetanide is __________ times more potent than frusemide
40
How does torsemide differ from other diuretics
eliminated by liver
loop with longer duration of action
torsemide
12 hrs
side effects of amiloride
Nausea
Flatulence
skin rash
why triamterene is contraindicated in pregnancy
It is a folic acid antagonist
adverse effect of triamterene
renal stones
use of aldosterone antagonists
adjunct to thiazides refractory HT anti arrythmogenic prevent proteinuria in DKD improve diastolic function
adverse effects of spironolactone
Hyperkalemia
gynacomastia
upper GI bleed
