Hypertension Flashcards
1
Q
Start medications
A
- > 60 years old with no CKD or DM
150/90 - <60 years old or any patient with CKD or DM
140/90
2
Q
Start preventive treatment
A
> 120/80
3
Q
Strategies to dose antihypertensive medications
A
- start one drug, titrate to maximum dose, then add second drug if goal not achieved
- start one drug, then add second drug before achieving maximum dose of initial drug
- begin with 2 drugs either as two separate pills or as a single pull combination
- may consider #3 if SBP >160 mmHg or if DBP >100 mmHg usually with a diuretic
4
Q
Causes of secondary hypertension
A
- intrinsic renal disease
- renovascular disease
- mineralocorticoid excess
- sleep disorders
- drug/alcohol induced
5
Q
Pallor, edema physical findings
A
renal disease
6
Q
Abdominal bruit physical finding
A
renovascular
7
Q
Truncal obesity, purple striae, buffalo hump
A
hypercortisolism
8
Q
RAAS system
A
- renin is normally produced in the kidneys in response to decreased intracellular volume
- angiotensin II is a potent vasoconstrictor
- aldosterone increases sodium and water reabsorption in the distal tubules
9
Q
Criteria for Metabolic Syndrome
A
- obesity with a waist circumference of >40” in men and >35” in women
- BP >130 mmHg SBP and/or >85 mmHg DBP
- FBS >110 mg/dL
- Serum triglycerides >150 mg/dL
- HDL cholesterol <40 mg/dL in men, <50 mg/dL in women
10
Q
> 60 years old
A
treatment goal: systolic <150 mmHg, diastolic <90 mmHg
11
Q
< 60 year old DBP
A
treatment goal: DBP <90 mmHg
12
Q
<60 year old SBP
A
treatment goal: SBP <140 mmHg
13
Q
> 18 year old with CKD
A
treatment goal: SBP <140 mmHg, DBP <90 mmHg
14
Q
> 18 year old with diabetic mellitus
A
treatment goal: SBP <140 mmHg, DBP <90 mmHg
15
Q
non-black population with or without DM treatment
A
meds include thiazide type diuretic, CCB, ACEI, ARB
