Hypertension Flashcards
Normal BP category
SBP/DP
SBP <120 & DP < 80
ELEVATED BP category
SBP 120-129
&
DB < 80
stage 1 HTN parameters
SBP 130- 139
OR
DP 80-89
stage 2 HTN category
SBP 140 or higher
OR
DP 90 or higher
Hypertensive crisis BP Parameters
SBP > 180 and/or
DP > 120
etiology of hypertensive crisis
- acute pain
- stroke
- renal failure
- non compliance with medication
- illicit drug use (cocaine, methamphetamines)
- HF
ACEI side effects
- Dry cough
- dizziness
- hypotension
- increased BUN & Cr
- Hyperkalemia
- angioedema
ARBS side effects
well tolerated
hypotension
less angioedema
Thiazide side effects
Hypo NA+, K+, Mag
hypercalcemia gout
hyperglycemia
dizziness
CCB (2 types) side effects
Dihydropyridines: dizziness, flushing, headache, edema
Non Hihydro: constipation, bradycardia, orthostatic hypotension
Hypertensive emergency definition
Urgency + target end organ damage (Chest pain, ischemia, ARF, Neuro deficit, pulmonary edema, Ao dissection, Eclampsia)
Hypertensive emergency treatment
Lower MAP 20-25 % in the first 1-2 hrs using a rapid acting and titratable agent (IV)
Hypertensive urgency definition
SBP >180 or diastolic > 110
Hypertensive urgency treatment
Lower BP over 24 - 48 hrs. Often can be done outpatient
In HTN emergency what is the medication of choice and why?
IV nicardepene
prevents rebound HTN and less side effects
Clevidipine
onest: 2 min
duration: 10 min
side effects: headache, reflex tachycardia
Esmolol
onset: 1 min
duration: 3-6 hrs
contraindications: 2nd, 3rd AV block, systolic HF, asthma, bradycardia
Labetolol
onset 5-10 min
duration 3 - 6 hrs
contraindications: 2nd, 3rd AV block, systolic HF, asthma, bradycardia
Nicardipine
onset: 5- 15 min
duration 4 - 6 hrs
contraindications: Liver failure
side effects: Headache, reflex tachycardia
Nitroglycerin
onset 1 - 5 min
duration 5 - 10 min
side effects: headache, reflex tachycardia
IVP Labetolol is a
non selective beta blocker (alph1 alpha 2)
Enalapril should not be given in patients with poor
renal function
Ace inhibitors are contraindicated in patients with
Contraindicated in renal artery stenosis
In African American adults with hypertension but without HF or CKD including those with DM what type of medication should be used?
thiazide diuretic or CCB or in combination should be used
In patients with CKD, with or without DM they should be started on an
ACEI or ARB or in combination with other drug classes
In non black patients with HTN they can be started on
a thiazide, an ACE, ARB, CCB alone or in combination.
