OnlineMedEd: Cardiology - "Hypertension" Flashcards
What are the JNC-8’s recommendations for the two tiers of BP control?
- Over 60 and without other diseases: less than 150/90
* Everyone else: less than 140/90
The three medications that you should use to control HTN are _____________.
CCBs, HTZ, and ACEi (or ARBs)
If the patient has chronic kidney disease, prescribe ___________.
an ACEi or an ARB
Those who are older than 75 or black should not be given _____________.
an ACEi
Go through the JNC-7’s stages (dated, but still useful).
- Pre-hypertension: 130-139 / 80-89
- Stage I HTN: 140-159 / 90-99
- Stage II HTN: 160-189 / 100-109
- Urgency: above 180 / above 110
- Emergency: urgency level with symptoms
Notice that you add 20 systolic and 10 diastolic between most stages.
For those with HTN and heart failure, use _____________.
beta-blockers and ACE inhibitors
Those with hypertensive emergency need _____________.
IV antihypertensives
What are the timeline criteria for lowering BP in a hypertensive emergency?
- 2-6 hours: lower by 25%
- 24-48 hours: return to normal levels
Faster than this can precipitate a stroke.
CCBs are great at treating those with HTN and ______________.
angina
Side effects of CCBs include _____________.
peripheral edema
If the person develops ____________ on an ACEi, then you should switch them to ARBs.
persistent cough or facial edema
List three antihypertensives that cause hyperkalemia.
- ACEi
- ARB
- Aldosterone receptor antagonists
What are two contraindications to receiving ACEis?
- Being older than 75
* Being AA
What is the big clinical association with clonidine and HTN?
Rebound HTN when stopped! Be careful. (This is especially relevant because clonidine is a TID medication and a single missed dose can cause hypertensive urgency.)
How should hypertension be diagnosed?
- Two readings over 140/90, two weeks apart, at two separate visits
- Ambulatory monitoring is the best, but it’s rarely used