Hypertension

Question 1

Long term HTN consequences

Answer 1

-left ventricular hypertrophy
-angina/MI
-coronary revascularization
-HF
-stroke/TIA
-CKD
-PVD
-Retinopathy

Question 2

essential HTN

Answer 2

-elevated arterial blood pressure

Question 3

secondary HTN

Answer 3

-elevated arterial BP due to med conditions or meds

Question 4

Isolated systolic HTN

Answer 4

-only systolic BP elevated

Question 5

Resistant HTN

Answer 5

-failt to attain goal BP on regimen of 3 agents at max dose (including diuretic)
-or when 4 or more agents needed

Question 6

Orthostatic HYPOtension

Answer 6

-systolic BP dec of > 20 mmHg
-diastolic BP dec >10 in 3 min of position change
-and/or inc in HR > 20 bpm

Question 7

Essential HTN patho

Answer 7

-humoral abnormalities
-neuronal mechs
-vascular endothelial mechs
-peripheral autoregulation defects
-electrolyte disturbances

Question 8

BP =

Answer 8

CO * TPR

Question 9

CO =

Answer 9

SV * HR

Question 10

modifiable HTN risk factors-

Answer 10

-high sodium intake
-obesity
-low potassium intake
-excess alcohol

Question 11

Non-modifiable risk factors HTN

Answer 11

-age
-race
-genes
-gender (female more under 64 esp under 55)

Question 12

Secondary HTN causes

Answer 12

-CKD
-renovasc disease
-primary aldosteronism
-obstructive sleep apnea
-drugs
-foods
-pheochromocytoma
-cushing’s/chronic steroid use
-thyroid or parathyroid disease
-aortic coarctation

Question 13

Substance that can INC BP

Answer 13

-drugs
-caffeine
-nicotine
-decongestants
-amphetamines
-antideppressants
-antipsychotics (-zapines)
-immunosuppressants (cyclosporine)
-contraceptives
-NSAIDs
-systemic steroids
-oncology agents

Question 14

BP measurement techniques

Answer 14

-in-office
-ambulatory BP monitoring (ABPM)
-home BP monitoring

Question 15

Normotensive

Answer 15

no HTN in office or at home

Question 16

sustained HTN

Answer 16

-HTN in office and at home

Question 17

masked HTN

Answer 17

-no HTN in office
-HTN at home

Question 18

white coat HTN

Answer 18

-HTN in office
-no HTN at home

Question 19

HBPM and ABPM considerations

Answer 19

-confirm diagnosis
-aid in med titration
-identify white coat and masked HTN
-better predictor of long term outcomes
-user error
-cost/insurance

Question 20

Normal BP

Answer 20

<120/<80

Question 21

Elevated BP

Answer 21

120-129/<80

Question 22

HTN stage 1

Answer 22

130-139 or/80-89

Question 23

HTN stage 2

Answer 23

> 140/ or >190

Question 24

Normal BP strategies

Answer 24

-promote healthy lifestyle
-comeback in 1 year

Question 25

Elevated BP strategies

Answer 25

-non-pharma
-reasses 3-6 months

Question 26

Stage 1 HTN strategies

Answer 26

-IF ASCVD risk > 10% or comorbidity, non pharm and meds reassess 1 month
-IF NOT, nonpharma reassess 3-6 months

Question 27

Stage 2 HTN strategy

Answer 27

-nonpharma + 2 meds
-reassess one month

Question 28

HTN patients at goal should follow up ehen

Answer 28

-every 3-6 months

Question 29

BP thresholds for tx

Answer 29

->140/90 for no clinical CVD and <10% ASCVD risk or secondary stroke prevention

Question 30

BP goals

Answer 30

-<130/80
-140/90 okay in elderly frail pt w high comorbidity burden and limited life expectancy
-<120 with CKD if tolerated

Question 31

trials?

Question 32

Nonpharma tx

Answer 32

-weight loss
-DASH diet**
-dec sodium intake
-inc potassium
-physical activity
-mod alcohol intake

Question 33

DASH diet

Answer 33

-fruits and veggies
-whole grains
-fat-free/low fat
-fish, poultry, beans
-nuts/vegetable oils
-potassium, ca, mg, fiber, protein
-limit saturated fats and sweets

Question 34

Pharma tx options

Answer 34

-Angiotensin-converting enzyme (ACEi)
-Angiotension receptor blockers (ARBs)
-Calcium Channel Blockers (CCB)
-direct renin inhibitors
-beta blockers
-diuretics
-alpha 1 blockers
-central a2 agonists
-vasodilators