Lecture 11 Hypertension Flashcards
HTN is defined as persistent systolic BP over _____ and/or diastolic over _____
140, 90
HTN urgency is defined as systolic greater than _____ and or diastoloic greater than _____. with or without end organ damage?
180, 120;
without
HTN emergency is defined as systolic greater than ____ and diastolic greater than _____. with or without end organ damage?
180, 120;
with
most common cause of HTN?
idiopathic/primary/essential
equation for MAP?
CO * TPR
CO and TPR:
which is dependent on myocardial contractility and preload?
which is determined by tone of the arterioles?
which is typically elevated in patients with HTN?
CO,
TPR,
TPR
3 instances that typically cause a release of renin:
- _______ sensed by macula densa cells
- _____ sensed by juxtaglomerular cells
where is it released from?
- decreased Na delivery
- decreased BP
- increased sympathetic tone (via B1 receptors)
Juxta glomerular cells
generally, the RAAS system causes a _____ in blood pressure via increased _____ activity and retention of ____ and _____
increase;
adrenergic
H2O, Na
most patients have ____ levels of Renin
“inappropriately normal”
ie normal levels, but should not be normal due to high bp
_____ nephron mass causes HTN
reduced
secondary HTN: renal =
usual cause in males _____
classic cause in females _____
athersclerosis (renal stenosis)
fibromuscular dysplasia
suspect ____ in patients with a triad of HTN, hypokalemia, and metabolic alkalosis
hyperaldosteronism
a high ____ ratio suggest hyperaldosteronism
aldosterone:renin
____ is important cause of HTN in children. what is a classic finding on physical exam
coarctation of the aorta;
HTN in arms, decreased bp in legs
eye findings with severe HTN: 3
retinal hemorrhages, exudates, and papilledema
HTN is based on an average of ____ or greater readings taken at ____ or greater office visits after initial screening visit
2, 2
patients with increased ______ mass have a marked increased risk of CVD (Cardiovascular disease)
LV
low risk patients (no diabetes, CKD, or organ damage) and are greater than ____ years old should be started with drugs at _____ over 90 mm Hg. patients younger than _____ years old should be started with drugs at _____ over 90
60, 150;
60, 140
high risk patients include those with ____, ____ or organ damage. they should be started on drugs with a goal to get below ____ over 80
diabetes, CKD
130 (according to JCN 7)
what is a DASH diet?
dietary approaches to stop HTN;
e.g. fruits/veggies, low fat
what are the 2 most common/extensively used drug classes to treat HTN
thiazide diuretics, ACE inhibitors (or ARB)
____ are especially indicated in patients with CAD, post MI, or LV dysfunction
beta blockers
_____ are indicated in patients with prostatism
alpha blockers
_____ improve survival in patients with increased cardiovascular risk by preventing LV remodeling
ACE inhibitors
what drug, besides thiazides, seems to be indicated in black patients with HTN?
calcium channel blockers
what drugs have been shown to improve outcomes in patients with kidney disease?
ACE inhibitors or ARBs
