Intro

Question 1

Most common chronic disease in Kentucky

Answer 1

hypertension

Question 2

What is hypertension?

Answer 2

An elevation in systolic and/or diastolic blood pressure, relative to normal for patient.

Question 3

What BP reading is generally classified as hypertension?

Answer 3

SBP > 140 and/or DBP > 90

Question 4

Isolated systolic hypertension (ISH) is most common in who?

Answer 4

Those over 60 years

Question 5

What BP reading is hypertensive crisis?

Answer 5

DBP > 110

Question 6

About what % of HTN cases are primary?

Answer 6

90%

Question 7

What is the cause of primary hypertension?

Answer 7

unknown (idiopathic)

Question 8

What groups typically have low renin HTN?

Answer 8

African Americans and elderly

Question 9

What are some drugs used to treat moderate/high renin HTN?

Answer 9

ACEi, ARB, diuretic

Question 10

What are some drugs used to treat low renin HTN?

Answer 10

diuretics, CCB, BB

Question 11

What BP reading does JNC8 recommend starting pharmacological therapy?

Answer 11

140/90

> 60 yo: BP > 150/90

Question 12

Secondary HTN can be caused by

Answer 12

renovascular disease
aortic narrowing
Primary aldosteronism
hyperadrenalism
hyperthyroidism
pregnancy
medication

Question 13

What are 4 mechanisms by which you can increase BP?

Answer 13

increase fluid intake
decrease fluid output
constrict vessels
increase cardiac output

Question 14

What is the immediate acting natural regulator of BP?

Answer 14

baroreceptor reflex

Question 15

What is the intermediate acting natural regulator of BP?

Answer 15

circulating vasoactive substances (epinephrine

Question 16

What is the long-term natural regulator of BP?

Answer 16

Renin, Angiotensin, Aldosterone System

Question 17

What is the single mechanism by which the body ultimately controls BP?

Answer 17

aldosterone : kidneys: fluid volume

Question 18

Where is renin released?

Answer 18

granular cells of JGA

Question 19

HTN is suspected to be a result of what underlying chronic disease?

Answer 19

renal failure

Question 20

Vasodilatory therapy always includes what?

Answer 20

diuretic

Question 21

What is the purpose of removal/ablation of efferent or afferent arterioles?

Answer 21

decreases sympathetic outflow and thus decreases renin release

Question 22

Variants of what enzyme is thought to be a genetic contributor of HTN?

Answer 22

STK39

Question 23

In whom was the enzyme associated with HTN identified?

Answer 23

Old Order Amish population

Question 24

In the case of the mutated enzyme associated with HTN, is polymorphism a result of elevated or decreased expression?

Answer 24

elevated STK39