Term
| Differentiate b/t primary and secondary HTN. |
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Definition
| primary - unknown cause, secondary - results from another condition |
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Term
| What is the most common type of HTN? |
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Definition
| primary (essential) - 90-95% of cases |
|
|
Term
| What race is HTN more common? |
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Definition
|
|
Term
|
Definition
| CO X systemic vascular resistance |
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|
Term
| What is the most important component of BP? |
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Definition
|
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Term
| What is the main risk factor associated with essential HTN? |
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Definition
|
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Term
| What are some lifestyle risk factors for essential HTN? |
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Definition
| obesity, dietary sodium, excess etoh, smoking, sedentary, NSAIDS, low K intake |
|
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Term
| What are some physiological risk factors associated with essential HTN? |
|
Definition
| renin elevation, defect in natriuresis, overactivity of sym NS, polycythemia |
|
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Term
| What are the 2 most common causes of secondary HTN? |
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Definition
| primary renal dz and renal vascular dz |
|
|
Term
| what other conditions cause secondary HTN? |
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Definition
| hyperaldosteronism, Cushing syndrome, OSA, coarctation of the aorta, pheochromocytoma, oral contraceptives, thyroid or parathyroid dz |
|
|
Term
| 4 clues to a dx of secondary HTN? |
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Definition
| 1) Severe or refractory HTN 2) Acute rise in stable BP 3) Onset before puberty 4) <30yo in a non-obese, non-black w/ no famhx |
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|
Term
| 3 major benefits to reducing BP? |
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Definition
| Decrease 1) Stroke 35-40% 2) MI 20-25% 3) HF >50% |
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|
Term
| what are the sx of uncomplicated HTN? |
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Definition
| almost always asymptomatic |
|
|
Term
| What is the most common sx of uncomplicated HTN? |
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Definition
|
|
Term
| What BP measured at home is considered to be HTN? |
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Definition
|
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Term
| What are components of metabolic syndrome which are CVD risk factors? (4) |
|
Definition
| 1) HTN 2) Obesity 3) Dyslipidemia 4) DM |
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Term
| What additional lab test should be assessed in a pt w/ HTN and DM? |
|
Definition
| microalbuminuria (or GFR <60) |
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Term
| It is recommended to a/w start w/ lifestyle modification to tx pre-HTN unless there is compelling evidence of clinical indication? Name 5. |
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Definition
| 1) POst MI 2) CHF 3) DM 4) CKD 5) CVA |
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Term
| Rec. tx for african americans w/ HTN? |
|
Definition
| Start w/ diuretics then add Ca channel blockers |
|
|
Term
|
Definition
| Beta blockers first choice, Ca channel blockers |
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|
Term
| Rec for tx of HTN w/ migraines? |
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Definition
|
|
Term
|
Definition
| Avoid diuretics b/c they can exacerbate gout |
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|
Term
| What are HTN urgencies? 4 examples. |
|
Definition
| BP must be red. w/i a few hrs. 1) Asymptomatic BP >220/125 2) Severe perioperative HTN 3) Optic disc edema 4) Target organ complications |
|
|
Term
|
Definition
| PO ACEI (captopril) and alpha2 antagonist (clonidine) |
|
|
Term
| What med should be avoided for HTN urgencies? Why? |
|
Definition
| Nifedipine SL - can cause CVA, unable to control rate or degree that BP falls |
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|
Term
|
Definition
| Requires immediate (w/i 1 hr) BP reduction to avoid risk of death or morbidity |
|
|
Term
| What level is considered HTN emergency? |
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Definition
|
|
Term
| 7 ex. of HTN emergencies? |
|
Definition
| 1) Encephalopathy 2) Nephropathy 3) ICH 4) AMI/unstable angina 5) DIssecting aortic aneurysm 6) Preeclampsia 7) Pulm. edema |
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|
Term
|
Definition
| Severe high BP w/ encephalopathy or nephropathy w/ papilledema |
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|
Term
| What is the goal in HTN emergency? |
|
Definition
| Decrease BP by 25% w/i min. to 1-2 hrs, then toward 160/100 in 2-6 hrs |
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|
Term
|
Definition
| 1) Vasodilators (nitroprusside Na, nitro) 2) Bblocker (labetalol or esmolol) 3) CCB (Nicardipin) 4) ACEI (Enalaprilat) |
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|
Term
| What should the clinician do in the case of resistant HTN? |
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Definition
|
|
Term
| JNC7 classification of normal BP? |
|
Definition
|
|
Term
| JNC7 classification of preHTN? |
|
Definition
|
|
Term
| JNC7 classification of stage I HTN? |
|
Definition
|
|
Term
| JNC7 classification of stage 2 HTN? |
|
Definition
|
|
Term
| JNC& rec. for diagnostic work-up of HTN? (6 steps) |
|
Definition
| 1) RF and comorb. 2) Identifiable causes 3) Target organ damage 4) H&P 5) Labs 6) EKG |
|
|
Term
| What age is considered a RF for CVD? |
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Definition
|
|
Term
| What BP is the goal for most pts w/ HTN? Pt w/ DM or CKD? |
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Definition
|
|
Term
| JNC7 rec. for initial drugs choices for Stage I HTN /s compelling indications? |
|
Definition
| Thiazide diuretics for most and consider ACEI, ARB, BB, CCB or combo. |
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|
Term
| TX for stage II HTN /s compelling indications? |
|
Definition
| 2 drug combo for most (thiazide diuretic and ACEI or ARB, or BB, or CC) |
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|
Term
| Initiac tx rec. for HF + HTN? |
|
Definition
| THIAZ, BB, ACEI, ARB, ALDO ANT |
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|
Term
| TX rec. for post MI + HTN? |
|
Definition
|
|
Term
| TX for high CVD risk + HTN? |
|
Definition
|
|
Term
|
Definition
| THIAZ, BB, ACEI, ARB, CCB |
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|
Term
|
Definition
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|
Term
| TX for recurrent stroke prevention + HTN? |
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Definition
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