Hypertension lecture

Question 1

Don’t give pt’s 500mg of digoxin it will kill the patient

Question 2

Hypertensive crisis is an acute condition of very high blood pressure (BP), with either: SBP > ____ mm Hg and/or DBP > mm Hg

Answer 2

SBP>180

DBP >120

Question 3

The presence of new or worsening end-organ damage differentiates hypertensive emergency from hypertensive urgency

Question 4

___________ of perfusion is a key physiological concept that explains the pathophysiology of hypertensive crisis

Answer 4

Autoregulation

Question 5

The affected organs during a hypertensive emergency commonly include: ______

________

_______

Vascular

Kidney

Answer 5

Brain

Eyes

heart

Question 6

____________does not require rapid (i.e., immediate) BP reduction because the benefit does not outweigh the risk

A more gradual BP reduction over several hours to days is optimal

Answer 6

Hypertensive urgency

Question 7

Hypertensive urgency is managed by resuming omitted antihypertensive therapy, increasing current doses of antihypertensives, or adding additional agents to achieve control

Question 8

____________ is a medical emergency that requires acute hospitalization, frequent monitoring, and, in most cases, intravenous (IV) antihypertensive therapy to control BP

Answer 8

Hypertensive emergency

Question 9

The goal for managing hypertensive emergencies is to prevent additional ________

Answer 9

additonal organ damage

Question 10

Target BP goals are different than those for chronic treatment of high BP, and the timeframe for achieving goals is determined by the organ systems affected and comorbidities

Question 11

Despite no clear mortality benefit with the use of IV antihypertensive agents, their use is still the standard of care intended to reduce further organ damage

Question 12

____________ is a modifiable risk factor that commonly leads to hypertensive crises

Answer 12

Medication nonadherence

Question 13

organ dysfunction in the setting of extreme BP elevations constitutes a medical emergency

Because acute target organ disease is present, the benefit of rapid BP lowering with IV antihypertensives generally outweighs the risk of potential ischemic complications

Question 14

The goal of treatment with IV antihypertensives is to prevent worsening organ dysfunction by targeting specific BP goals.

Question 15

shifts in autoregulation that make intensive BP lowering suboptimal for organ perfusion. Therefore, overly aggressive BP lowering places patients at risk for ischemic complications

gradual lowering of BP with oral antihypertensives in hypertensive urgency.