Term
| In persons older than 50 years, what is the most important component of blood pressure to CVD risk? |
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Definition
| - systolic blood pressure of more than 140mmHg in comparison to diastolic blood pressure |
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Term
| The risk of CVD beginning at what blood pressure doubles with each increment of what other blood pressure? |
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Definition
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Term
| At what point after initiating anti-hypertensive treatment should an additional antihypertensive agent be considered? |
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Definition
| - if the current BP is greater than or equal to 20/10mmHg above the goal BP |
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Term
| What is the most important factor in determining the effectiveness of antihypertensive treatment plan for patients? |
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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" |
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Term
For the following BP classification, what are the following:
systolic BP
diastolic BP
lifestyle modification?
initial drug therapy?
BP classification: normal |
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Definition
1) 0-120
2) 0-80
3) encourage
4) n/a |
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Term
For the following BP classification, what are the following:
systolic BP
diastolic BP
lifestyle modification?
initial drug therapy?
BP classification: prehypertension |
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Definition
1) 120-139
2) 80-89
3) no drug indicated; drugs for compelling indication (CKD, DM) |
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Term
For the following BP classification, what are the following:
systolic BP
diastolic BP
lifestyle modification?
initial drug therapy?
BP classification: stage 1 hypertension |
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Definition
1) 140-159
2) 90-99
3) thiazide; ACEi, ARB, BB, CCB//drug for indication w/ other antihypertensive drug |
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Term
For the following BP classification, what are the following:
systolic BP
diastolic BP
lifestyle modification?
initial drug therapy?
BP classification: stage 2 hypertension |
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Definition
1) 160+
2) 100+
3) yes
4) 2 drug combination (one is thiazide)//drugs for indication w/ other antihypertensives |
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Term
| What is required for the classification of BP in pt's 18+y/o |
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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 |
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Term
| What is the lifetime risk for developing hypertension in pts normotensive at 55yrso? |
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Definition
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Term
| What are the major benefits of lowering BP? |
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Definition
- stroke prevention (40% decreased incidence)
- MI prevention (25% decreased incidence)
- HF prevention (50% decreased incidence) |
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Term
| By what factor does BP decrease during the night? |
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Definition
- 10-20%
- will not decrease in pts at increased risk for cardiovascular events |
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Term
| If a pt comes in reporting that self-measured BP mean of greater than what number is indicative of hypertension? |
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Definition
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Term
| What are the major goals of patient evaluation of hypertension? |
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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 |
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Term
| What should the physical examination of a pt w/ hypertension include? |
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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 |
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Term
| What are the major risk factors for cardiovascular disease |
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Definition
- hypertension
- cigarette smoking
- obesity
- physical inactivity
- dyslipidemia
- diabetes mellitus
- microalbuminuria/renal insufficiency
- age (M55+;F65+)
- FHx |
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Term
| What is the target BP for pts with hypertension? hypertension plus DM? |
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Definition
1) 140/90
2) 130/80
*goal should be targeting the systolic since most achieve diastolic after systolic goal is met* |
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Term
| What is the approximate systolic BP reduction for each of the major lifestyle modifications to manage hypertension? |
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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) |
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Term
What is the class and usual dose (mg/d) and frequency of the following drug:
chlorthalidone
hydrochlorothiazide |
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Definition
thiazide
1) 12.5-25 qd
2) 12.5-50 qd |
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Term
What is the class and usual dose (mg/d) and frequency of the following drug:
furosemide (lasix) |
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Definition
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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 |
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Term
What is the class and usual dose (mg/d) and frequency of the following drug:
spironolactone (aldactone) |
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Definition
aldosterone-receptor blockers
1) 25-50mg/d; qd/BID |
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Term
What is the class and usual dose (mg/d) and frequency of the following drug:
atenolol
metoprolol (lopressor) |
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Definition
beta-blockers
1) 25-100mg/d; qd
2) 50-100mg/d; qd/bid |
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Term
What is the class and usual dose (mg/d) and frequency of the following drug:
acebutolol (sectral) |
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Definition
BB w/ ISA
1) 200-800mg/d; BID |
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Term
What is the class and usual dose (mg/d) and frequency of the following drug:
labetalol |
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Definition
combined alpha and beta blockers
1) 200-800mg/d; BID |
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Term
What is the class and usual dose (mg/d) and frequency of the following drug:
captopril
lisinopril |
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Definition
ACEi
1) 25-100mg/d; BID
2) 10-40mg/d; qd |
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Term
What is the class and usual dose (mg/d) and frequency of the following drug:
losartan |
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Definition
- antiotensin II antagonists
1) 25-100mg/d; qd/BID |
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Term
What is the class and usual dose (mg/d) and frequency of the following drug:
diltiazem ER
verapamil SR |
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Definition
CCB-nondihydropyridine
1) 180-420mg/d; qd
2) 120-360mg/d; qd/BID |
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Term
What is the class and usual dose (mg/d) and frequency of the following drug:
amlodipine |
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Definition
- CCB- dihydropyridine
1) 2.5-10mg/d; qd |
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Term
What is the class and usual dose (mg/d) and frequency of the following drug:
prazosin |
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Definition
alpha-1 antagonist
1) 2-20mg/d; BID/TID |
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Term
What is the class and usual dose (mg/d) and frequency of the following drug:
clonidine |
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Definition
- alpha2-agonist
1) 0.1-0.8mg/d; BID |
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Term
What is the class and usual dose (mg/d) and frequency of the following drug:
hydralazine |
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Definition
- direct vasodilator
- 25-100mg/d; BID |
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Term
| Define: metabolic syndrome |
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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) |
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Term
| Define: postural hypotension |
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Definition
| - decrease in standing systolic BP of more than 10 mmHg when associated with dizziness or fainting |
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Term
| What are the preferred medications for the safety of the fetus in pts with hypertension and pregnancy |
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Definition
1) methyldopa
- beta-blockers
- vasodilators |
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Term
| What are the potential favorable s/e of HTN tx? |
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Definition
1) slowing demineralization in osteoporosis (thiazide)
2) atrial tachyarrhythmias/fibrillation, migraine, thyrotoxicosis, essential tremor, perioperative hypertension (BB)
3) raynaud syndrome, arrhythmias (CCB) |
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Term
| What are the potential unfavorable s/e of HTN tx? |
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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) |
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Term
| What ar ethe major causes of resistant hypertension |
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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 |
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