Hypertension

Question 1

There is a direct relationship between ______ and _______ disease

Answer 1

hypertension, cardiovascular

Question 2

____ _______ is the force exerted by the blood against the walls of the blood vessels

Answer 2

Blood pressure

Question 3

Hypertension affects __% of the adults in the US

Answer 3

33

Question 4

Hypertension’s nickname is the ____ _____

Answer 4

silent killer

Question 5

Stage 1 Hypertension ranges from systolic pressures ______ or diastolic pressures _______

Answer 5

140-159, 90-99

Question 6

Prehypertension ranges from systolic pressures ____ or diastolic pressures ____

Answer 6

120-139, 80-89

Question 7

When only the systolic pressure is elevated, it is known as ______ _______ _______

Answer 7

isolated systolic hypertension

Question 8

Stage 2 Hypertension ranges from systolic pressures ______ or diastolic pressures _______

Answer 8

160 or higher, 100 or higher

Question 9

List the four processes that regulate blood pressure

Answer 9

Arterial baroreceptors, body-fluid volume, Renin-Angiotensin system, vascular autoregulation

Question 10

The _____ _______ produces vasoactive substances to maintain low arterial tone

Answer 10

vascular endothelium

Question 11

The renal system controls ____ excretion and ___ volume

Answer 11

sodium, ECF

Question 12

This kind of hypertension is responsible for 90%-95% of all cases. It has no known underlying cause.

Answer 12

Primary hypertension (idiopathic hypertension or essential hypertension)

Question 13

This kind of hypertension is responsible for 5%-10% of all cases. It has an underlying cause.

Answer 13

Secondary hypertension

Question 14

Two causes of primary hypertension, though not known why they happen, are increased _____ _______ ______ and increased _____ ______

Answer 14

peripheral vascular resistance, blood volume

Question 15

List some risk factors for primary hypertension

Answer 15

Age, alcohol, tobacco, diabetes mellitus, elevated serum lipids, excess dietary sodium, gender, family history, stress, obesity, ethnicity, sedentary lifestyle, socioeconomic status

Question 16

Having a systolic blood pressure (SBP) greater than 140 after age 50 is a predictor of ________ risk

Answer 16

cardiovascular

Question 17

Older adults are more likely to have ____ ______ hypertension, _____ hypertension, and ______ HYPOtension

Answer 17

“white coat”, orthostatic, postprandial

Question 18

What type of hypertension is most common in adults over 50 years of age?

Answer 18

Isolated systolic hypertension

Question 19

Alcohol should be limited to how many drinks per day?

Answer 19

one for women, two for men

Question 20

Later symptoms of hypertension include:

Answer 20

Fatigue, dizziness, dyspnea, angina, palpitations

Question 21

For diagnostic testing, blood pressure should be taken in ___ arms, and know blood pressure is highest in early ____ and lowest at _____

Answer 21

both, morning, night

Question 22

For ____ ____ ______ _____, there should be two readings on each occasion, two minutes apart, and at least two separate occasions

Answer 22

ambulatory blood pressure monitoring

Question 23

Patient should be seated quietly for ___ minutes before having blood pressure taken

Answer 23

five

Question 24

Losing 22lbs may decrease systolic blood pressure by __ to ___ mmHg

Answer 24

5, 20

Question 25

For those with hypertension, ____ modification is key.

Answer 25

lifestyle

Question 26

With sodium reduction, the patient should consume no more than ___ grams of sodium per day

Answer 26

2.4

Question 27

What diet promotes eating more fruits and vegetables and less red meats in those with hypertension?

Answer 27

DASH

Question 28

In addition to lifestyle changes, what might the physician prescribe to the patient to treat Stage 1 hypertension?

Answer 28

One drug, usually a diuretic.

Question 29

With Stage 2 hypertension, what two kinds of drugs are normally prescribed?

Answer 29

A diuretic and ACE inhibitor

Question 30

What are the three determinants of blood pressure?

Answer 30

PVR, cardiac output, and volume of blood

Question 31

With diuretics, we want to make sure potassium levels are normal. What is the normal range of blood potassium?

Answer 31

3.5-5.0

Question 32

Adrenergic inhibiting agents decrease the _____ nervous system’s effects in the body. There are ___ acting and _____ acting drugs.

Answer 32

sympathetic, central, peripheral

Question 33

Three side effects of adrenergic inhibiting agents are?

Answer 33

dry mouth, erectile dysfunction, orthostatic hypotension

Question 34

What is used mostly only for hypertensive crises? How are they administered?

Answer 34

direct vasodialators, IV only

Question 35

Name and describe the two angiotensin inhibitors

Answer 35

1. Angiotensin converting enzyme (ACE) inhibitors prevent conversion of AI to A2. NSAIDs reduce effect of drug.
2. Angiotensin II receptor blockers (ARBs) prevent AII from binding to its receptors to vessel walls, but takes 3-6 weeks for full effect.

Question 36

With calcium channel blockers, you want to avoid what type of juice? You also do not want to prescribe them to patients with what ailment?

Answer 36

grapefruit, heart failure

Question 37

True or False: If a patient misses a dose of diuretic, he/she should double up the next time a dose is due.

Answer 37

False

Question 38

Over the counter meds should be avoided while taking hypertension. Some examples are what?

Answer 38

Antacids, Ginseng, Ephedra (now off market), NSAIDs

Question 39

What is the difference between a hypertensive emergency and a hypertensive urgency?

Answer 39

An emergency occurs over hours to days. The time frame is more important than the pressure in this case. Typical pressure for an emergency is > 220/140 with a target organ disease.

An urgency occurs over days to weeks. Pressure is around >180/110 with no clinical evidence of target organ disease.

Question 40

A __________ _____ is often related to amphetamine or cocaine use, or those who have not complied with hypertension treatment before. Clinical manifestations are headache, rise in blood pressure, nausea, vomiting, seizures, confusion, and coma (encephalopathy)

Answer 40

hypertensive crisis

Question 41

Manifestations of target organ disease on hypertensive crises are what?

Answer 41

Cardiac–ECG shows evidence of heart failure

Cerebrovascular–stroke

Peripheral vascular–one or more major pulses (excluding dorsalis pedis) reduced or absent, bruits, aneurysm

Renal–serum creatinine > or = 1.5 mg/dL

Retinopathy–narrowing of retinal arterioles or hemmorhages

Question 42

True or false: During a hypertensive crisis, you want to gradually reduce the blood pressure

Answer 42

True. Reducing too quickly may result in decreased organ perfusion

Question 43

You don’t want to decrease the MAP by more than ___% within minutes to hours during a hypertensive crisis

Answer 43

25