Hypertension Flashcards
less than normal BP readings
systolic less than 120 AND diastolic less than 80
elevated BP readings
systolic 120-129 AND diastolic less than 80
Stage 1 hypertension BP readings
systolic 130-139 OR diastolic 80-89
Stage 2 hypertension BP readings
systolic greater than or equal to 140 OR diastolic greater than or equal to 90
in patients with elevated BP or stage 1 HTN with NO clinical ASCVD or estimated 10-year risk LESS than 10%, what is the recommended treatment/follow-up time?
nonpharmacologic therapy then reassess in 3-6 months
in patients with stage 1 HTN with clinical ASCVD or estimated 10-year risk greater than or equal to 10%, what is the recommended treatment/follow-up time?
nonpharmacologic therapy and BP-lowering medication, reassess in 1 month
BP threshold for antihypertensive therapy initiation and BP goal for patients with:
- clinical CVD or 10-year ASCVD risk greater than or equal to 10%
- diabetes
- chronic kidney disease or chronic kidney disease postrenal transplantation
- HF
- stable ischemic heart disease
- peripheral arterial disease
threshold: greater than or equal to 130/80
goal: less than 130/80
BP threshold for antihypertensive therapy initiation and BP goal for patients with no clinical CVD and 10-year ASCVD risk less than 10% OR in secondary stroke prevention
threshold: greater than or equal to 140/90
goal: less than 130/80
BP threshold for antihypertensive therapy initiation and BP goal for patients that are older persons (greater than or equal to 65, noninstitutionalized ambulatory, community living adults)
threshold: greater than or equal to 130 systolic
goal: less than 130 systolic
which class of BP drugs should NOT be used in HFrEF patients?
CCBs
which classes of BP drugs should NOT be used in HFpEF patients?
aldosterone antagonists, CCBs, direct vasodilators
which class of BP drug should NOT be used in stable ischemic heart disease?
direct vasodilators
what are the 2 classes of BP drugs that can be used in patients with chronic kidney disease?
ACE inhibitors or ARBs
which class of BP drugs should be used in postrenal transplant patients?
CCBs
which classes of BP drugs should be used in diabetes patients?
diuretics, CCBs
which classes of BP drugs should be used in secondary stroke prevention patients?
diuretics, ACE inhibitors, ARBs
which class of BP drugs should be used in atrial fibrillation patients?
ARBs
which classes of BP drugs should NOT be used in peripheral arterial disease patients?
aldosterone antagonists, beta blockers, direct vasodilators
which class of BP drugs should be used in patients with thoracic aortic disease?
beta blockers
adrenal steroid hormones, amphotericin B, cocaine/amphetamines/other illicit drugs, cyclosporine and tacrolimus, erythropoietin, some herbal products, highly active antiretroviral therapy (HAART), inadequate diuretic therapy, natural licorice, neurologic and psychiatric agents (venlafaxine, lithium, thioridazine), NSAIDs, OC hormones, recent caffeine or nicotine use, sympathomimetics (decongestants, anorectics, stimulants), vascular endothelial growth factor inhibitors (bevacizumab, sorafenib, sunitinib)
medications that can cause drug induced HTN
patients that would benefit from initial therapy with two antihypertensive agents from different classes
stage 2 HTN and average BP more than 20/10 above their BP target
weight modification, adopt DASH eating plan, dietary sodium restriction, physical activity, moderation of alcohol consumption
lifestyle modifications for patients with HTN
examples of cardioselective beta blockers, better in patients with asthma/COPD, peripheral vascular disease
atenolol, bisoprolol, metoprolol
examples of non-selective beta blockers
nadolol, nebivolol, propranolol
