Lecture 1 Hypertension

Question 1

Hypertension exists when BP > __-__ using automated measurement methods

Answer 1

135/85

Question 2

SPRINT population =

Answer 2

High risk patients >50 yrs old at high risk for CVD including known CVD,CKD, Framingham >15%, Age> 75

Question 3

Orthostatic Hypotension

Answer 3

Sudden drop in BP when you stand from a seated or lying position —> dizziness

Defined as a BP drop of >20/10 mmHg within 2-3 minutes of standing. In patients with a normal autonomic system, this is unlikely.

Most common in elderly

Does not appear to be associated with increased risk of falling, but requires strategies to manage

Question 4

Resistant hypertension

Answer 4

Failure to achieve BP target despite treatment with three antihypertensive drugs at optimal doses

Important to check adherence and measure Bp properly

Prevalence is not well studied, appears to be about 10-30% of hypertensive patients

Question 5

Hypertension emergency and urgency

Answer 5

Emergency: Target organ damage such as acute left ventricular failure, acute myocardial ischemia, aortic dissection, encephalopathy, papilledema in conjunction with high Bp

Urgency: asymptomatic, DBP>10mmHg

Question 6

Primary Hypertension

Answer 6

85-90% of those with hypertension have primary hypertension

Factors felt to be implicated:
- increased sympathetic neural activity
- increased angiotensin II and aldosterone activity