Week 2 - Hypertension

Question 1

True or false. The overall approach to management of most hypertensive patients should be to focus only on getting them to improve their blood pressure numbers.

Answer 1

False, The overall goal should be to address modification of ALL modifiable risk factors for cardiovascular disease, in addition to lowering BP.

Question 2

Which of the following management plans is most appropriate for a patient with pre-hypertension?

Select one:

a. target blood pressure to =115/75
b. counsel the patient on healthy lifestyle changes and cardiovascular risks associated with hypertension
c. counsel the patient on lifestyle changes/risks and refer them for anti-hypertensive medication

Answer 2

B

Question 3

According to the ESH-ESC 2013 guidelines, how long should you counsel a patient with stage 1 HTN (aka grade 1 HTN) regarding lifestyle changes before referring them for medication if BP does not reach the goal of <140/90?

Answer 3

several months

Question 4

True or false. If a patient needs to be referred for prescription medication to lower BP you should counsel them that they will need to take the anti-hypertensive medication forever.

Answer 4

False, You should counsel them that taking medication to help lower blood pressure may only be necessary temporarily if they are able to make lifestyle changes.

Question 5

For patients in the 30-59 year old age range, there is sufficient evidence from well-designed, well-executed randomized controlled trials (RCTs) that lowering diastolic blood pressure (DBP) to <90 results in decreased mortality rates.

Answer 5

True

Question 6

At what age do the JNC8 guidelines suggest starting to use a less aggressive target BP treatment goal of <150/90 if a patient does not have diabetes or renal disease?

Answer 6

≥ 60 years old

Question 7

With certain co-morbidities, the management plan for stage 1 hypertensives involves lifestyle counseling and immediate referral for anti-hypertensive medication. Which of the following groups does NOT fall into this category?

Select one:

a. patients with liver disease
b. patients with renal disease
c. diabetics
d. patients with a history of stroke
e. patients with congestive heart failure (CHF)

Answer 7

A

Question 8

True or false. Patients with very high stage 2 HTN, BP >180/110, should be started on prescription anti-hypertensive medication immediately.

Answer 8

True

Question 9

Weight loss is a key component of HTN management in any patient with BMI >25%. A weight loss of 10% is associated with which of the following decreases in systolic blood pressure (SBP)?

Select one:

a. 0-5 points
b. 5-10 points
c. 5-20 points
d. 20-25 points

Answer 9

c. 5-20 points

Question 10

True or false. As part of counseling patients on healthy lifestyle choices, you should advise patients to avoid all alcohol to decrease their risk of cardiovascular disease.

Answer 10

False, safe levels of alcohol use do not increase the risk of cardiovascular disease; for men this ≤ 2 drinks/day and for women this is ≤ 1 drink per day.