Hypertension (no meds) Flashcards
Who gets hypertension more, men or women?
about equal!
At what age does the risk for hypertension increase greatly
55
What % of americans have hypertension? Pre-HTN?
33%, another 30% pre HTN
Which race has the greatest incidence of HTN
blacks
What is the value for “normal” BP?
119/79
What is the value for “pre-hypertensive”
120-139 / 80-89
What is the value for “stage 1 hypertension”
140-159/ 90-99
What is the value for “stage 2 hypertension”
160+ / 100+
What are the 7 modifiable risk factors that Mr. B said we needed to know for HTN
- smoking
- high sodium diet
- excess alcohol
- obesity
- physical inactivity
- dislipidemia
- vitamin D deficiency
What are the 4 NON-modifiable risk factors that Mr. B said we needed to know for HTN
- Age 55+
- race (African American)
- Family history
- personality (impatience, depression)
What are the classic symptoms of Pheochromocytoma
headache
sweating (flush)
tachycardia
hypertension
What are the classic symptoms of Cushing’s Syndrome
skin atrophy striae proximal muscle weakness buffalo hump hypertension
What are the classic symptoms of Hyperaldosteronism
hypokalemia
metabolic alkalosis
hypertension
When you are checking BP in both arms in children, what are you looking for?
coarctation of aorta
What is the gold standard for diagnosing HTN
ambulatory blood pressure monitoring
serial measurements!
If ambulatory blood pressure monitoring is not available, what is an alternative?
home BP monitoring
automated office BP
Erroneously high BP is called:
white coat BP
Erroneously low BP is called:
masked BP
At what time of day is BP most accurate?
nocturnal BP readings
What four things should the patient avoid doing before taking their BP
- caffeine consumption
- smoke
- eat
- exercise
Can you diagnose HTN with one BP reading
don’t be a dumbass of course not!
SERIAL READINGS
What agents can cause HTN
estrogen
sympathomimetics
adrenal steroids
What signs and symptoms during a patient history would be indicative of target organ damage
headache transient weakness transient blindness loss of visual acuity chest pain dyspnea claudication
What signs and symptoms during a patient history would lead you to believe the hypertension is secondary (versus primary)
muscle weakness tachycardia sweats tremors skin thinning flank pain sleep apnea
What tests should be ordered for patients with HTN
Lipid Panel
Urinalysis
Basic Metabolic Panel (glucose, creatinine, electrolytes)
EKG
What is the FIRST LINE treatment for HTN
lifestyle modifications
What are the lifestyle modifications a patient should do if they have HTN
DASH diet decrease sodium intake decrease alcohol intake exercise 3-4 x week for 40 min healthy weight smoking cessation
Treatment threshold is ____/____, unless you are over 60 (and otherwise healthy), then it is ____/_____
140/90
150/90
What is the threshold for treatment in a patient who is 65 years old and has diabetes
140/90
because of the diabetes
What is it called when a patient is on three different HTN medications and still has high BP readings
resistant hypertension
