OnlineMedEd: Cardiology - "Hypertension" Flashcards

1
Q

What are the JNC-8’s recommendations for the two tiers of BP control?

A
  • Over 60 and without other diseases: less than 150/90

* Everyone else: less than 140/90

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2
Q

The three medications that you should use to control HTN are _____________.

A

CCBs, HTZ, and ACEi (or ARBs)

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3
Q

If the patient has chronic kidney disease, prescribe ___________.

A

an ACEi or an ARB

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4
Q

Those who are older than 75 or black should not be given _____________.

A

an ACEi

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5
Q

Go through the JNC-7’s stages (dated, but still useful).

A
  • 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.

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6
Q

For those with HTN and heart failure, use _____________.

A

beta-blockers and ACE inhibitors

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7
Q

Those with hypertensive emergency need _____________.

A

IV antihypertensives

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8
Q

What are the timeline criteria for lowering BP in a hypertensive emergency?

A
  • 2-6 hours: lower by 25%
  • 24-48 hours: return to normal levels

Faster than this can precipitate a stroke.

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9
Q

CCBs are great at treating those with HTN and ______________.

A

angina

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10
Q

Side effects of CCBs include _____________.

A

peripheral edema

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11
Q

If the person develops ____________ on an ACEi, then you should switch them to ARBs.

A

persistent cough or facial edema

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12
Q

List three antihypertensives that cause hyperkalemia.

A
  • ACEi
  • ARB
  • Aldosterone receptor antagonists
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13
Q

What are two contraindications to receiving ACEis?

A
  • Being older than 75

* Being AA

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14
Q

What is the big clinical association with clonidine and HTN?

A

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.)

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15
Q

How should hypertension be diagnosed?

A
  • Two readings over 140/90, two weeks apart, at two separate visits
  • Ambulatory monitoring is the best, but it’s rarely used
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16
Q

How is secondary hypertension diagnosed?

A
  • Any hypertension in a person younger than 35

* Hypertension refractory to 3 or more antihypertensives, with one being a diuretic

17
Q

Go through Dustyn’s mnemonic for secondary hypertension.

A
HHHARPCO
• Hypercalcemia
•Hyperthyroidism
• Hyperaldosteronism
• Aortic coarctation
•Renal vascular occlusion/stenosis
•Pheochromocytoma
•Cushing's syndrome
• OSA
18
Q

What are the recommendations from the SPRINT trial?

A
  • If you are older than 60, target BP is less than 150/90.
  • If you are younger than 50, target BP is less than 140/90.

No longer based on co-morbid conditions!