Hypertension Flashcards
What is the most likely complication to occur with chronic hypertension?
Stroke
What are the classifications of blood pressure?
Normal: <120/<80
Pre-Htn: 120-139/80-89
Stage 1: 140-159/90-99
Stage 2: >160/>100
What are the treatments for the stages of hypertension?
Normal/Pre Htn - Lifestyle modification (no drugs)
Stage 1 - LSM, Mono-combo
Stage 2 - LSM, Combo
Does lowering BP prevent strokes or MIs better?
Strokes
What are common indications of hypertension?
Heart Failure
Diabetes w/ proteinuria
CAD
Chronic Renal Insufficiency
CVA
What is necessary to produce sustained hypertension?
Renal involvement
An altered renal “set point” for sodium retention/excretion
What are the two best screening tests for renovascular hypertension?
Captopril renogram
Arteriorgram
How does hyperaldosteronism cause hypertension?
Autonomous aldosterone production leads to ecf expansion and increased BP
Very high BP, surpressed renin levels and nonstimulatable
What is pheochromocytoma?
Autonomous production of vasoconstrictors epinephrine and norepinephrine
Increaes in TPR define physiology, however catecholamines may blunt natriuresis so volume depletion is not sufficient to prevent hypertension
What is the majority cause of hypertension?
Essential (combination of genetics and environment)
Secondary causes (i.e. pathologies) much less common
What is malignant hypertension?
Medical emergency
Evidence for acute vascular injury in context of hypertension, usually found on retinal examination
Who should be evaluated for secondary hypertension?
Hypertension presenting early
Hypertension without a family history
Severe or difficult to control hypertension
What are the types of renovascular hypertension?
Fibromuscular dysplasia - familial, responds well to correction
Athermomatous - correlates with PVD
What are types of hyperaldosteronism?
Adrenal tumor (Conn’s syndrome)
Adrenal hyperplasia (Glucocorticoid sens/insens)
Pseudohyperaldosteronism (licorice/tobaccos, Liddle’s)
How is hyperaldosteronism evaluated?
Hypokalemia
Hypokalemia in the face of ACE inhibitor is a red flag
Goal is to demonstrate suppressed renin and non-suppressible aldosterone
