primary and secondary HTN

Question 1

lowering BP can reduce the risk of…

Answer 1

stroke incidence
MI
heart failure

Question 2

white coat HTN

Answer 2

high BP in office, normal at home

Question 3

Masked HTN

Answer 3

normal BP in office, high at home

Question 4

HTN can target kidneys and cause _____

Answer 4

CKD

Question 5

at what BP do you start treatment for a pt with no CVD and a low risk

Answer 5

140/90

Question 6

lifestyle modifications for HTN

Answer 6

weight loss
DASH diet
exercise
moderation of alcohol

Question 7

stage 1 HTN

Answer 7

systolic 130-139 or diastolic 80-89

Question 8

stage 2 HTN

Answer 8

systolic 140+ or diastolic 90+

Question 9

which lifestyle mod can have the largest impact on BP reduction

Answer 9

weight loss

Question 10

how long should rx take to start to help in stage 2 HTN?

Answer 10

should work immediately

Question 11

goal BP for adults with HTN and CVD or CVD event risk 10%+

Answer 11

BP less than 130/80

Question 12

how much will 1 rx change BP?

Answer 12

8/5 mmHg

Question 13

how much will 2 rx change BP?

Answer 13

15/9 mmHg

Question 14

___ of the world’s population has HTN

Answer 14

25%

Question 15

when to suspect secondary HTN

Answer 15

<30 years old at onset
resistant HTN
malignant HTN
sudden onset

Question 16

most common correctable cause of secondary HTN

Answer 16

renovascular HTN

Question 17

2 causes of renovascular HTN

Answer 17

fibromuscular dysplasia

atherosclerosis

Question 18

most common cause of renovascular HTN in young females

Answer 18

fibromuscular dysplasia

Question 19

what is fibromuscular dysplasia?

Answer 19

non-atherosclerotic medial fibroplasia where there are alternating areas of thin and thick areas of the renal arteries

Question 20

most common cause of renovascular HTN

Answer 20

atherosclerosis

Question 21

causes of secondary HTN

Answer 21

renal artery stenosis
endocrine causes
coarctation of aorta
sleep apnea

Question 22

sleep apnea tx

Answer 22

CPAP

Question 23

how does sleep apnea cause secondary HTN

Answer 23

hypoxia and hypercapnia increase SNS activity and RAAS

Question 24

how does coarctation of aorta cause secondary HTN

Answer 24

HTN in upper limbs

reduced BP in lower limbs because there is a narrowing of the aortic lumen

Question 25

aldosterone _____ BP

Answer 25

increases

Question 26

cause of HTN where there is unregulated aldosterone release from the adrenal gland

Answer 26

primary hyperaldosteronism

Question 27

clinical presentation of secondary HTN

Answer 27

new refractory HTN
hypokalemia
metabolic acidosis

Question 28

renovascular HTN pathophys

Answer 28

narrowing of one or both renal arteries leads to obstruction of blood flow-ischemia and renin release which increases sodium retention and PVR leading to HTN

Question 29

how does renin lead to HTN?

Answer 29

increased angiotensin leads to increased aldosterone which increases Na retention and PVR leading to HTN

Question 30

imaging for suspected secondary HTN

Answer 30

renal ultrasound

Question 31

renovascular HTN treatment

Answer 31

RAAS inhibitors
CCBs
diuretics

Question 32

aldosterone increases BO by…

Answer 32

Na retention in the kidney
direct vasoconstriction
SNS upregulation via CNS

Question 33

2 causes of primary hyperaldosteronism

Answer 33

adrenal hyperplasia (bilateral)
adrenal adenoma (unilateral)

Question 34

adrenal hyperplasia tx

Answer 34

MRA aldactone or eplerenone

Question 35

adrenal adenoma tx

Answer 35

adrenalectomy as long as unilateral

Question 36

Cushing’s syndrome causes secondary HTN by

Answer 36

excess cortisol production

Question 37

delayed femoral pulses

Answer 37

coarctation of aorta

Question 38

patients with renal parenchymal disease have reductions in ____ which leads to _____

Answer 38

sodium excretion

HTN