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Cardiovascular > Hypertension > Flashcards

Hypertension Flashcards

1
Q

What is Hypertension?

A

Abnormally high BP measured at 140/ 90 mm Hg or higher.

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2
Q

What is mm Hg?

A

Millimetres of mercury, measuring unit for BP

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3
Q

What is the optimal BP?

A

< 120 / 80 mm Hg

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4
Q

What is normal BP?

A

< 130 / 85 mm Hg

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5
Q

What is borderline BP?

A

130-139/ 85-89 mm Hg

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6
Q

What is Stage I BP?

A

140-159/ 90-99 mm Hg

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7
Q

What is Stage II BP?

A

160-179/ 100-109 mm Hg

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8
Q

What is Stage II BP?

A

> 180/ >110 mm Hg

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9
Q

Prevalence of Hypertension?

A

20% of population

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10
Q

Etiology of Hypertension?

A

Idiopathic. But most commonly seen in: 1. older patients 2. If over 50 = family hx, 3. Mild hypertension

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11
Q

Symptoms of HPT?

A

Asymptomatic

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12
Q

Signs of HPT?

A

Measured BP of 140/ 90 mm Hg

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13
Q

Tx - Non-pharmacological

A
  1. Limit Salt Intake
  2. Weight Loss
  3. Regular Exercise
  4. Limit Alcohol
  5. Smoke Cessation
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14
Q

Tx - Pharmacological (list 1st - last line of treatment)

A
  1. Diuretics
  2. ACE Inhibitor/ ARB
  3. CCB
  4. Beta Blockers
  5. Miscellaneous
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15
Q

Mechanism of action of diuretics?

A

Diuretics are drugs that increase flow of urine. AKA - diuretics are agents that decrease extracellular fluid volume. This happens by the following mechanisms:

  1. inhibition of an active transport process
  2. alteration of epithelial ion permeability
  3. inhibition of energy-producing processes in cells
  4. alteration or intrarenal hemodynamics
  5. antagonism of endogenous hormones

Notes from 2011 Dents: decreases plasma volume > decreases Na and K

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16
Q

List 3 diuretics

A
  1. Hydrochlorthiazide
  2. Chlorthalidone
  3. Indapamide

Hint - chlor

17
Q

What does ACE [inhibitor] stand for?

A

Angiotensin-converting enzyme [inhibitor]

18
Q

Mechanism of ACE inhibitors

A

Decrease preload and afterload = vasodilation = can cause cough in 15% of pts.

Hint - pril

WIKI mechanism: ACE inhibitors inhibit angiotensin-converting enzyme (a component of the blood pressure-regulating renin-angiotensin system), thereby decreasing the tension of blood vessels and blood volume, thus lowering blood pressure.

19
Q

List 4 ACE inhibitors?

A
  1. Captropril
  2. Enalapril
  3. Perindopril
  4. Ramipril
20
Q

What does ARB stand for?

A

Angiotensin Receptor Blocker

21
Q

Mechanism of ARBs

A

ARBS are used when pt is intolerant of ACE inhibitor therapy. Pts intolerant to ACE inhibitor therapy don’t inhibit the breakdown of bradykinin (along with other kinins) thus associate with persistent dry cough or angioedema which limit ACE inhibitor therapy.

Mechanism same as ACE I. - Decrease preload and afterload = vasodilation

22
Q

List 4 ARBs

A
  1. Losarten
  2. Olmesartan
  3. Valsartan
  4. Telmisartan

Hint - sartan

23
Q

Mechanism of beta blockers

A

Blocks beta receptors > decreases BP and HR

24
Q

List 4 beta blockers

A
  1. Metoprolol
  2. Atenolol
  3. Propanolol
  4. Bisoprolol

Hint - olol

25
Q

What does CCB stand for

A

Calcium Channel Blockers

26
Q

Mechanism CCB?

A

Decrease rate and contractility, vasodilatory (peripheral, coronary and pulmonary)

27
Q

List 5 CCB

A
  1. Verapamil
  2. Amlodipine
  3. Nifedipine
  4. Diltiazem
  5. Felodipine

Hint - dipine

28
Q

Miscellaneous drugs used to treat hypertension

A
  1. Clonidine
  2. Minoxidil
  3. Methyldopa
  4. Spironolactone

*Dont treat pt if they are on these, red flag

29
Q

General Dental Considerations

A
  1. Review frequency and results of BP monitoring
  2. Review med list
  3. Ask about complications from HPT
30
Q

Dental considerations day of surgery

A
  1. Ask pt to anti-hypertensive therapy meds day of surgery
  2. be mindful that emotional stress/ pain can elevate BP
  3. change in position can precipitate hypotension
  4. minimize the use of vasopressors (vasoconstrictor)
  5. AVOID surgery if HPT is 180/ 110 or more or symptomatic

Cardiovascular (7 decks)

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