Hypertension Flashcards
As a PCP the DC is well positioned to screen for
Hypertension
Hypertension may lead to
Heart failure
Aortic disection
Renal failure
Leading cause of hemorrhagic stroke
Hypertension causes
Poor diet
Lack of exercise and bad habits
Lack of exercise and bad habits cause ___ of hypertension
90%
Normal BP
<120 mmHg systolic and <80 mmHg diastolic
Elevated hypertension
120-129 mmHg systolic and <80 mmHg
Stage 1 hypertension
130-139 mmHg systolic or 80-89 diastolic
Stage 2 hypertension
> 140 mmHg systolic or >90 mmHg diastolic
New staging has resulted in ___ of US population has hypertension instead of 32%
42%
Now most ____ adults have hypertension
Black
56% women, 59% men
Everyone over 65 should be treated if systolic is
> 130
Prehypertension category
Doesn’t exist
Remains the most common dx in US
Hypertension
CV disease ___ in healthcare costs
320Billion
Risk of HTP increases with
Age
Primary HTN =
95% of cases
Hypertenstion exam wait ___ after smoking or drinking
30-60 minutes
Mercury sphygmomanometer is
Preferable
If normal BP at 55, still have 90% chance of developing
Hypertension
False increased BP may be caused by
Too small of cuff Pain Caffeine anxiety Full pt bladder Cold weather Deflating bladder too rapidly Recent alcohol or nicotine
False low BP may be due to
Too large of cuff Recent meal Leaky bulb Deflating too rapidly Bell pressure too hard
White coat syndrome effect
Systolic inc 5.3-6.9 mmHg
Unsupported arm effect
Diastolic inc 10%
Back not supported effect
Diastolic inc 6 mmHg
Crossed legs effect
Systolic inc 8 mmHg
Lack of calibration effect
46% failure rate in privare
Indicators for secondary hypertension
Drug resistant HTN Abrupt onset of HTN Onset >30 yo Onset of diastolic HTN in geriatric Unprovoked hypokalemia
4 most common causes of secondary HTN
Renal dz
Renal artery dz
Primary aldosteronism
Obstructive sleep apnea
Atrial fib is
On the rise
__ of atrial fibrillation patients have HTN
80%
Most common comorbid condition
Atrial fibrillation
Elevated BP
Lifestyle modification advice and re-chekc in 3 months
Stage 1 BP
One BP lowering drug
Stage 2 BP
2 BP lowering drugs and lifestyle modifications
5 major categories of HTN drugs
Diuretics Angiotenson converting enzyme (ace) inhibitors Angiotenson receptor blockers (ARBs) Calcium channel blockers Alpha-blockers
No drgu was better than __ for first time outcome
Thiazides
Screen patients for HTN normal BP
Recommend lifestyle changes as a preventative measure
For those with elevated BP or stage 1 without clinical CV dz
Recommend lifestyle changes for 3 months then re-check
For stage 2
Refer to internist
