Hypertension

Question 1

What are some factors that control BP?

Answer 1

RAAS=Increase BP
Baroreceptors»Autonomic NS
Endocrine System>epinephrine, ADH (both increase BP)

Question 2

What is the difference between primary and secondary HTN?

Answer 2

Primary=unknown cause
Secondary=known and correctable cause

Question 3

Risk factors for HTN

Answer 3

> 50 yo
Alcohol
Smoking
Diabetes
Black
High sodium
Fam hx
Male
High cholesterol
Obese
Sedentary
Lower economic
Stress

Question 4

S/Sx of HTN

Answer 4

Many times no s/sx
But may have:
Fatigue
Dizziness
Palpitations
Angina
Dyspnea

Headaches may indicate hypertensive crisis.

Question 5

Which organs are most damaged from HTN?

Answer 5

Heart
Brain
Peripheral vessels
Kidneys
Eyes

Question 6

What is intermittent claudication?

Answer 6

Pain in legs made worse by activity and relieved by rest.
This is classic sign or PVD (peripheral vascular disease)

Question 7

Damage to vessels of retina indicates…

Answer 7

Similar vessel damage in heart, brain, kidneys

This may present at blurred vision, vision loss, retinal hemorrhage.

Question 8

What is a hypertensive crisis?

Answer 8

A BP of >180/120 WITH target organ damage
This is the difference between hypertensive crisis and hypertensive urgency–the presence of target organ damage.

Question 9

S/sx of hypertensive crisis

Answer 9

Blurred vision
Chest pain
confusion
Dyspnea
Headache
N/V
Nosebleeds
Seizures

Question 10

What is the goal for MAP in hypertensive crisis?

Answer 10

Drop the MAP by no more than 20-25%

Question 11

Hydrochlorothiazide info

Answer 11

Thiazide diuretic/antihypertensive
Inhibits reabsorption of Na and all other electrolytes and water in kidneys.
SE: hypokalemia
Watch for electrolyte imbalances

Question 12

Diltiazem info

Answer 12

Calcium channel blocker
Works by blocking movement of calcium into heart and vascular muscle.
Relaxes and lowers BP, Given in angina
Don’t give if have AV block

Question 13

Nitroprusside info

Answer 13

Antihypertensive/vasodilator
Relaxes smooth muscle of vessels
RAPID hypotensive effect
Given in hypertensive crisis
SE: Nausea, dizziness, headache, abdominal pain
Watch for rebound HTN after D/C

Question 14

Captopril info

Answer 14

ACE inhibitor
Stops RAAS system from raising BP
Given for: HTN, HF (especially after MI)
SE: hypotension, COUGH
Admin on empty stomach

Question 15

Propranolol info

Answer 15

Beta blocker
Blocks B1 and B2
Lowers HR, BP
Uses: HTN, angina, arrhythmias, MI, alcohol W/D, social anxiety, PTSD
SE: ED, fatigue, weakness, bronchospasm (careful with asthma patients)
Always taper off slowly