S2 L1.3: SAH Classifications (Etiology & Treatment) Flashcards
Classification According to Etiology
Elevated BP w/o a cause, d/t aging (same as to Primary Htn
Essential Htn
Classification According to Etiology
Elevated BP wtih an identifiable cause d/t another medical condition that manifests with elevated BP
Secondary HTN
T/F: When the condition is classified as Secondary Htn, if it is resolved, the hypertension will be resolved as well
True
Release excessive levels of catecholamines, epinephrine, norepinephrine, dopamine, etc
Pheochromocytoma
Tumor in the adrenal gland that secretes a lot of aldosterone
Hyperaldosteronism
Patients who snore at night and stop breathing for a while
Obstructive Sleep Apnea (OSA)
Condition: Occurs to patients with damaged kidneys and those with end stage renal diseases (e.g. renal failure)
Renal Parenchymal Htn
Condition: Narrowing of one or both renal arteries and cause activation or RAA system causing volume expansion
Renal Artery Stenosis
In Renal Artery Stenosis:
Blood flow entering the kidneys → JG cells would sense that and it will always release their renins because of that stimulus; it will always think less blood going into the kidneys → RAA would ?
overly be stimulate
Condition: Excessive renin secretion & Sympathetic overactivity
Renal Parenchymal Htn
Condition: Increase catecholamines cause diastolic hypertension
Hypothyroidism
Condition: Increase in cardiac output and decrease IN PVR cause systolic HTN
Hyperthyroidism
Condition: Adrenal tumor cause increase in BP and low potassium (Aldosterone causes the increase in BP)
Primary Hyperaldoteronism
Condition: Excessive growth hormone release cause increased cardiac output; treat this to resolve elevated BP
Cushing Syndrome
Pts with excessive fat present with elevated BP
Clues to Secondary Htn (4)
1.Onset of HPN at age <20 or onset of diastolic HPN at >50
2. Target organ damage presentation
3. Presence of features indicative of secondary causes
4. Poor response to generally effective treatment
Presence of features indicative of secondary causes
Abdominal bruit on rigid physical examination (kidney area) → ?
renal artery stenosis
Presence of features indicative of secondary causes
Labile HTN with tachycardia (and excessive sweating) → ?
Sign of pheochromocytoma
Classifications According to Need for Treatment
a. Hypertensive Emergency
b. Hypertensive Urgency
c. HCVD
d. White Coat Htn
BP >220/140; needs to be brought down immediately
a. Hypertensive Emergency
Classifications According to Need for Treatment
a. Hypertensive Emergency
b. Hypertensive Urgency
c. HCVD
d. White Coat Htn
With acute target organ damage (e.g. brain, heart, kidneys) - Important distinction from urgency to emergency
a. Hypertensive Emergency
Classifications According to Need for Treatment
a. Hypertensive Emergency
b. Hypertensive Urgency
c. HCVD
d. White Coat Htn
Symptoms
○ Chest pain
○ Changes in sensorium
○ Weakness
○ Slurring of speech
○ Abdominal pain
a. Hypertensive Emergency
Classifications According to Need for Treatment
a. Hypertensive Emergency
b. Hypertensive Urgency
c. HCVD
d. White Coat Htn
BP>180/100; BP lowering is more slowly (No target organ damage, No symptoms)
b. Hypertensive Urgency
Strategy of treatment is to lower BP gradually (except ischemic strokes)
Classifications According to Need for Treatment
a. Hypertensive Emergency
b. Hypertensive Urgency
c. HCVD
d. White Coat Htn
As PTs, cut the session short and let the patient rest and take medications; continue PT session on another day
b. Hypertensive Urgency
Classifications According to Need for Treatment
a. Hypertensive Emergency
b. Hypertensive Urgency
c. HCVD
d. White Coat Htn
Applied for chronic uncontrolled hypertension
c. HCVD
Classifications According to Need for Treatment
a. Hypertensive Emergency
b. Hypertensive Urgency
c. HCVD
d. White Coat Htn
Chronic complications of HTN:
○ Retinopathy
○ Cardiomegaly, Left vetricular hypertrophy
○ Heart failure, cardiomyopathy
○ Kidney failure
○ Peripheral vascular disease
c. HCVD
Classifications According to Need for Treatment
a. Hypertensive Emergency
b. Hypertensive Urgency
c. HCVD
d. White Coat Htn
Elevated BP readings taken in clinics/offices
Normal home BP readings
d. White Coat Htn
