Hypertension

Question 1

Guyton Hypothesis of Essential Hypertension

Answer 1

Primary defect in renal Na+ excretion
Increase in plasma volume
Increase in CO 
Autoregulatory increase in SVR 
Increase in BP (and afterload-mediated normalization of CO)

Question 2

Cellular hypothesis of essential hypertension

Answer 2

Inhibition of Na/K/ATPase
Increase in vascular smooth muscle cell Na
Decreased driving force for Na/Ca exchange
Increase in cell Ca
Increase in SVR
Increase in BP

Question 3

Normal blood pressure

Answer 3

< 80

Question 4

Prehypertension

Answer 4

120-139 / 80-89

Question 5

Stage 1 Hypertension

Answer 5

140-159 / 90-99

Question 6

Stage 2 Hypertension

Answer 6

> 160 / > 100

Question 7

HTN Treatment Goals - General Population

Answer 7

< 140 / 90

Question 8

HTN Treatment Goals - Pts with Diabetes/Chronic Kidney Disease

Answer 8

< 130 / 80

Question 9

Treatment - Prehypertension

Answer 9

Lifestyle modification (smoking cessation, weight loss, salt reduction); no drugs indicated

Question 10

Treatment - Stage I Hypertension

Answer 10

Thiazide diuretic

Question 11

Treatment - Stage II Hypertension

Answer 11

2 drug combination, thiazide diuretic + ACEI/ARB, or BB, or CCB

Question 12

What is the lifetime risk of developing HTN?

Answer 12

90%

Question 13

What is the risk of CV and renal complications with HTN?

Answer 13

Starting at 115/75 mmHg, the risk of CVD doubles with each increase of 20 / 10 mmHg

Question 14

Identifiable causes of high BP

Answer 14

Sleep apnea 
Chronic kidney disease
Primary aldosteronism 
Renovascular disease 
Cushing's disease / chronic steroid therapy 
Coarctation of the aorta
Thyroid / Parathyroid disease