Shared Flashcard Set

Details

Family Medicine - Hypertension
asdf
38
Other
Graduate
06/25/2011

Additional Other Flashcards

 


 

Cards

Term
In persons older than 50 years, what is the most important component of blood pressure to CVD risk?
Definition
- systolic blood pressure of more than 140mmHg in comparison to diastolic blood pressure
Term
The risk of CVD beginning at what blood pressure doubles with each increment of what other blood pressure?
Definition
1) 115/75
2) 20/10
Term
At what point after initiating anti-hypertensive treatment should an additional antihypertensive agent be considered?
Definition
- if the current BP is greater than or equal to 20/10mmHg above the goal BP
Term
What is the most important factor in determining the effectiveness of antihypertensive treatment plan for patients?
Definition
- their motivation, "the most effective therapy prescribed by the most careful clinician will control hypertension only if patients are motivated. Motivation improves when patients have positive experiences with and trust in the clinician"
Term
For the following BP classification, what are the following:

systolic BP
diastolic BP
lifestyle modification?
initial drug therapy?

BP classification: normal
Definition
1) 0-120
2) 0-80
3) encourage
4) n/a
Term
For the following BP classification, what are the following:

systolic BP
diastolic BP
lifestyle modification?
initial drug therapy?

BP classification: prehypertension
Definition
1) 120-139
2) 80-89
3) no drug indicated; drugs for compelling indication (CKD, DM)
Term
For the following BP classification, what are the following:

systolic BP
diastolic BP
lifestyle modification?
initial drug therapy?

BP classification: stage 1 hypertension
Definition
1) 140-159
2) 90-99
3) thiazide; ACEi, ARB, BB, CCB//drug for indication w/ other antihypertensive drug
Term
For the following BP classification, what are the following:

systolic BP
diastolic BP
lifestyle modification?
initial drug therapy?

BP classification: stage 2 hypertension
Definition
1) 160+
2) 100+
3) yes
4) 2 drug combination (one is thiazide)//drugs for indication w/ other antihypertensives
Term
What is required for the classification of BP in pt's 18+y/o
Definition
1) mean of 2 or more properly measured seated BP readings on each of 2 or more office visits
2) seated quietly for at least 5 minutes in chair
3) properly calibrated instrument should be used
- appropriate sized cuff
- arm at heart level
- go slow enough to hear heart sounds
Term
What is the lifetime risk for developing hypertension in pts normotensive at 55yrso?
Definition
- 90+%
Term
What are the major benefits of lowering BP?
Definition
- stroke prevention (40% decreased incidence)
- MI prevention (25% decreased incidence)
- HF prevention (50% decreased incidence)
Term
By what factor does BP decrease during the night?
Definition
- 10-20%
- will not decrease in pts at increased risk for cardiovascular events
Term
If a pt comes in reporting that self-measured BP mean of greater than what number is indicative of hypertension?
Definition
1) 135/85
Term
What are the major goals of patient evaluation of hypertension?
Definition
1) assess lifetyle and ID CV risk factors
2) reveal causes of high BP
3) assess presence/absence of target-organ damage and CVD
Term
What should the physical examination of a pt w/ hypertension include?
Definition
- appropriate measurement of BP w/ verification in contralateral arm
- examin optic fundi
- BMI calculation
- auscultation of bruits
- palpation of thyroid
- heart and lung exam
- abd exam
- palpation of lE edema and pulses
- neuro assessment
Term
What are the major risk factors for cardiovascular disease
Definition
- hypertension
- cigarette smoking
- obesity
- physical inactivity
- dyslipidemia
- diabetes mellitus
- microalbuminuria/renal insufficiency
- age (M55+;F65+)
- FHx
Term
What is the target BP for pts with hypertension? hypertension plus DM?
Definition
1) 140/90
2) 130/80

*goal should be targeting the systolic since most achieve diastolic after systolic goal is met*
Term
What is the approximate systolic BP reduction for each of the major lifestyle modifications to manage hypertension?
Definition
1) weight reduction (5-20mmHg/10kg)
2) adopt DASH eating plan (8-14mmHg)
3) dietary sodium reduction (2-8mmHg)
4) physical activity (4-9mmHg)
5) moderation of alcohol consumption (2-4mmHg)
Term
What is the class and usual dose (mg/d) and frequency of the following drug:

chlorthalidone
hydrochlorothiazide
Definition
thiazide
1) 12.5-25 qd
2) 12.5-50 qd
Term
What is the class and usual dose (mg/d) and frequency of the following drug:

furosemide (lasix)
Definition
loop
1) 20-80; BID
Term
What is the class and usual dose (mg/d) and frequency of the following drug:

amiloride (midamor)
Definition
potassium-sparring diuretics
1) 5-10mg/d; qd/BID
Term
What is the class and usual dose (mg/d) and frequency of the following drug:

spironolactone (aldactone)
Definition
aldosterone-receptor blockers
1) 25-50mg/d; qd/BID
Term
What is the class and usual dose (mg/d) and frequency of the following drug:

atenolol
metoprolol (lopressor)
Definition
beta-blockers
1) 25-100mg/d; qd
2) 50-100mg/d; qd/bid
Term
What is the class and usual dose (mg/d) and frequency of the following drug:

acebutolol (sectral)
Definition
BB w/ ISA
1) 200-800mg/d; BID
Term
What is the class and usual dose (mg/d) and frequency of the following drug:

labetalol
Definition
combined alpha and beta blockers
1) 200-800mg/d; BID
Term
What is the class and usual dose (mg/d) and frequency of the following drug:

captopril
lisinopril
Definition
ACEi
1) 25-100mg/d; BID
2) 10-40mg/d; qd
Term
What is the class and usual dose (mg/d) and frequency of the following drug:

losartan
Definition
- antiotensin II antagonists
1) 25-100mg/d; qd/BID
Term
What is the class and usual dose (mg/d) and frequency of the following drug:

diltiazem ER
verapamil SR
Definition
CCB-nondihydropyridine
1) 180-420mg/d; qd
2) 120-360mg/d; qd/BID
Term
What is the class and usual dose (mg/d) and frequency of the following drug:

amlodipine
Definition
- CCB- dihydropyridine
1) 2.5-10mg/d; qd
Term
What is the class and usual dose (mg/d) and frequency of the following drug:

prazosin
Definition
alpha-1 antagonist
1) 2-20mg/d; BID/TID
Term
What is the class and usual dose (mg/d) and frequency of the following drug:

clonidine
Definition
- alpha2-agonist
1) 0.1-0.8mg/d; BID
Term
What is the class and usual dose (mg/d) and frequency of the following drug:

hydralazine
Definition
- direct vasodilator
- 25-100mg/d; BID
Term
Define: metabolic syndrome
Definition
- presence of 3+ of the following:
1) abd obesity (M40+in; F35+in)
2) glu intolerance (110+mg/dL fasting)
3) high TG (150+mg/dL)
4) BP (130/85+)
5) low HDL (M0-40mg/dL; F0-50mg/dL)
Term
Define: postural hypotension
Definition
- decrease in standing systolic BP of more than 10 mmHg when associated with dizziness or fainting
Term
What are the preferred medications for the safety of the fetus in pts with hypertension and pregnancy
Definition
1) methyldopa
- beta-blockers
- vasodilators
Term
What are the potential favorable s/e of HTN tx?
Definition
1) slowing demineralization in osteoporosis (thiazide)
2) atrial tachyarrhythmias/fibrillation, migraine, thyrotoxicosis, essential tremor, perioperative hypertension (BB)
3) raynaud syndrome, arrhythmias (CCB)
Term
What are the potential unfavorable s/e of HTN tx?
Definition
1) gout, hyponatremia (thiazide)
2) asthma, RAD, 3deg heart block (BB)
3) teratogenic (ACEi/ARB)
4) angioedema (ACEi)
5) hyperkalemia (Aldosterone antagonist, K-sparring)
Term
What ar ethe major causes of resistant hypertension
Definition
- improper BP measurement
- volume overload/pseudotolerance (excessive Na, volume retention, inadequate therapy)
- nonadherence
- inadequate dosease
- COX-2i
- illicit drugs
- OCP
- EPO
- icorice
- obesity
- excess alcohol intake
- causes of HTN
Supporting users have an ad free experience!