(MHD) Hypertension

Question 1

What systolic/diastolic values define hypetension? What else is used to define hypertension?

Answer 1

140/90

Or current use of antihypertensives

Question 2

BP range for prehypertension

Answer 2

sys: 120-139

or

dia: 80-90

Question 3

BP range for stage 1 hypertension

Answer 3

sys: 140-159

or

dia: 90-99

Question 4

BP range for stage 2 hypertension

Answer 4

sys: greater than 160

or

dia: greater than 100

Question 5

Essential HTN

Answer 5

Observed hypertension as the pt gets older (in order to compensate for vasculular changes with time)

Question 6

What is malignant HTN? Who is it common in? What are its symtoms (4)

Answer 6

A form of HTN which can occur w/o any preexisiting HTN. Most likely due to hyperplastic ateriosclerosis. More likely in younger AA males.

1. N/V
2. Encephalopathy
3. retinal issues (papilledema/hemorrhages)
4. Renal Failure

Question 7

Describe pseudohypertension

Answer 7

Peripheral arteries become very rigid from advanced (often calcified) arteriosclerosis, so the cugg has to be at a higher pressure to compress the artery. This causes a false elevation of BP measurement.

Question 8

Resistant HTN

Answer 8

Failure to reach BP goal in pts who are adhering to full doses or an appropriate drug regimen. Should prompy consideration of secondary causes.

Question 9

Hypertensive Urgency

Answer 9

Severe elevation in BP WITHOUT acute end-organ damage. Usually can be treated w/o extensive work-up.

(this differs from a hypertensive emergency)

Question 10

Hypertensive Emergency

Answer 10

Severe elevation in BP WITH acute end-organ damage

This is a medical emergency and the patient must be hospitalized in order to lower the BP

Question 11

What are the specific goals for treatment in hypertensive emergencies?

Answer 11

Immediate lowering of BP

1. reduce MAP (max of 10-20% in 1 hr)
2. Reduce up to 25-30% of BP in first 24 hrs
3. Transition to oral medications after target pressure stabilizes

Question 12

What are exceptions to the normal treatment of hypertensive emergencies (2)?

Answer 12

1. Dissecting Aneurysm (BP is lowered rapidly to 100-120mmHg)
2. Acute phase of ischemic stroke (reperfusion indicated)

Question 13

Symptoms of HTN

Answer 13

Often none (the silent killer)

Usually only appear if there is organ damage. Sometimes there are headaches.

Question 14

What is the goal for hypertension treatment for pts under 60? Over 60? Diabetics?

Answer 14

Under 60 and Diabetics: get BP < 140/90

Over 60: get BP < 150/90