Hypertension Flashcards

1
Q

Prevalence of HTN in US

A
  • 50-60 million people
  • 50% of 60-70 yo
  • 65% of 70-80 yo
  • 70% of 80+
  • normotensive ppl @ age 55 have 90% risk of developing HTN
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2
Q

CVD risk associated with HTN

A
  • Starting @ 115/75, CVD risk doubles w/each increase of 20/10 mmHG
  • positive linear association between systolic BP and ischemic HD mortality
    • more important risk factor in persons > 50 yo (vs. diastolic)
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3
Q

Essential HTN pathogenesis (2 theories)

A
  • MAP = CO x SVR
  • Theory 1: defect in renal sodium excretion => increased plasma volume => increased CO => autoregulatory increase in SVR => increase in BP
  • Theory 2: Na+ transport inhibitor inhibits Na+/K+/ATPase => increases cell Na+, cell can’t extrude Ca2+ via NCX => increases cell Ca2+ => VSMC contraction => increase in SVR/BP
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4
Q

Elements of lifestyle modification tx for HTN

A
  • Weight reduction
    • 5-20 mmHg/10kg weight loss
  • DASH eating plan
    • 8-14 mmHg reduction
  • Dietary sodium reduction
    • 2-8 mmHg reduction
  • Increase physical activity
    • 4-9 mmHg reduction
  • Moderation of alcohol
    • 2-4 mmHg reduction
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5
Q

Classification of HTN

A
  • Normal = <120/<80
  • PreHTN = 120-139/80-89
  • Stage 1 HTN = 140-159/90-99
  • Stage 2 HTN = >160/>100
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6
Q

PreHTN tx

A
  • lifestyle modification
  • no antiHTN drugs
  • if pt has chronic kidney disease, give drugs for this/other compelling indication
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7
Q

Stage 1 HTN tx

A
  • lifestyle modification
  • thiazide diuretics for most
  • may consider ACE-i, ARB, BB, CCB or combo
  • drugs for compelling indications (e.g. chronic kidney disease)
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8
Q

Stage 2 HTN tx

A
  • lifestyle modification
  • Two drug combo: thiazide diuretics + ACE-i/ARB or BB or CCB
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9
Q

Secondary HTN definition/pathogenesis

A
  • Secondary hypertension (secondary high blood pressure) = high BP caused by another medical condition.
  • can be caused by conditions that affect your kidneys, arteries, heart or endocrine system.
  • can also occur during pregnancy.
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10
Q

Tx of secondary HTN

A
  • control both the underlying condition and the high blood pressure ==>
  • reduces the risk of serious complications — including heart disease, kidney failure and stroke.
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11
Q

CVD risk factors

A
  • HTN
  • tobacco use
  • physical inactivity
  • metabolic syndrome: obese, diabetes, dyslipidemia
  • microalbuminuria/GFR <60 ml/min
  • age
  • Fhx
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12
Q

Possible causes of HTN

A
  • sleep apnea
  • drug-induce
  • chronic kidney disease
  • primary aldosteronism
  • renovascular disease
  • chronic steroids/Cushing’s
  • coarctation of aorta
  • thyroid/parathyroid disease
  • RAD PACTS: reno, apnea, drug, primary, aorta coarc, chronic, thyroid, steroids
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13
Q
A
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