Term
| force of blood against the walls of the blood vessels |
|
Definition
|
|
Term
| force of blood in the arteries when the heart beats |
|
Definition
|
|
Term
| force of blood in the arteries when the heart is relaxed |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| "essential"; idiopathic; Renin Angiotensin Aldosterone System; neurological/receptor abnormalities; vasodilation/vasoconstriction imbalances |
|
Definition
|
|
Term
| sleep apnea; drug induced; CKD; primary aldosteronism, Cushing's, pehochromocytoma; coarctation of the aorta; thyroid or parathyroid disease; renal artery stenosis |
|
Definition
|
|
Term
| JNC 7 Guidelines Definitions |
|
Definition
| define hypertension and prehypertension |
|
|
Term
| 2014 Guidelines Definitions |
|
Definition
| definitions not addressed but only thresholds for medication treatment |
|
|
Term
| JNC 7 Guidelines Treatment Goals |
|
Definition
| separate for uncomplicated and subsets with comorbid conditions |
|
|
Term
| 2014 Guidelines Treatment Goals |
|
Definition
| Similar goals for all patients with hypertension |
|
|
Term
| JNC 7 Guidelines Lifestyle |
|
Definition
| recommended based on literature review and opinion |
|
|
Term
| 2014 Guidelines Lifestyle |
|
Definition
| endorses, recommendations of the Lifestyle Work Group |
|
|
Term
| JNC 7 Guidelines Drug Therapy |
|
Definition
| 5 classes for initial therapy with Thiazides for most patients |
|
|
Term
| 2014 Guidelines Drug Therapy |
|
Definition
| 4 drug classes with separate recommendations for racial CKD and Diabetic groups |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Factors Affecting SVR: Sensors |
|
Definition
| baroreceptors, JG apparatus, atrium |
|
|
Term
| Factors Affecting SVR: Effectors |
|
Definition
| vasoconstrictors, vasodilators, others |
|
|
Term
| Factors Affecting SVR: Mediators |
|
Definition
| blood pressure, distal tubule Cl- delivery, atrial stretch |
|
|
Term
| overproduction of sympathetic hormones (occurs rarely but changes the way you treat hypertension) |
|
Definition
|
|
Term
|
Definition
| may increase blood pressure |
|
|
Term
| contraindicated in pregnancy |
|
Definition
|
|
Term
|
Definition
| start txt when BP is 150/90. treat to goal of < 150/90 |
|
|
Term
|
Definition
| start txt when BP is >140/90. treat to goals of < 140/90 |
|
|
Term
| patients > 18 years with CKD, people with diabetes and > 18 |
|
Definition
| initiate when BP is > 140/90 |
|
|
Term
| nonblack population including those with diabetes |
|
Definition
| thiazide-type diuretic, CCB, ACE-I or ARB |
|
|
Term
| black population, including those with diabetes |
|
Definition
| include thiazide-type diuretic or a CCB |
|
|
Term
| people aged > 18 years with CKD |
|
Definition
| initial includes ACE-I or ARB |
|
|
Term
|
Definition
| SBP > 200 mmHg; DBP > 100 mmHg; without target end organ damage; usually do not require hospitalization; oral antihypertensive therapy |
|
|
Term
|
Definition
| SBP > 200 mmHg; DBP > 100 mmHg; w/ target end organ damage; requires hospitalization; IV antihypertensives |
|
|
Term
|
Definition
| encephalopathy, MI, unstable angina, pulmonary edema, eclampsia, stroke, head trauma, life threatening arterial bleeding, aortic dissection |
|
|
Term
|
Definition
| multifactorial (BP measurement technique, Na+, diuresis, medications, ETOH, identifiable causes) |
|
|
Term
|
Definition
| Hydrochlorothiazide, chlorthalidone, metolazone |
|
|
Term
|
Definition
| Furosemide, Bumetanide, Ethacrynic acid, Torsemide |
|
|
Term
| inhibits Na+/Cl- absorption in the distal tubule --> vasodilation |
|
Definition
|
|
Term
| thiazide diuretics ineffective: |
|
Definition
| when renal insufficiency present (<30 ml/min) or if on NSAIDs; cross sensitivity with sulfa allergy |
|
|
Term
|
Definition
| inexpensive, benefits in osteoporosis, metalozone beneficial in low GFR - add on therapy, elderly and African American patients respond more |
|
|
Term
|
Definition
| hypokalemia; hyponatremia; hyperlipidemia; hyperglycemia; hypomagnesemia; hypercalcemia; sexual dysfunction |
|
|
Term
|
Definition
| take in morning; watch input/output; watch for potassium supplementation |
|
|
Term
|
Definition
| furosemide, bumetanide, ethacrynic acid, torsemide |
|
|
Term
| inhibits reabsorption of Cl- in asecending Loop of Henle |
|
Definition
|
|
Term
| rapid and short acting, can be used in renal insufficiency, cross sensitivity with sulfa allergy (except for ethacrynic acid) |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| hypokelmia, hypocalcemia, hypomagnesemia, ototoxicity, hyponatremia, phototoxicity, dehydration |
|
|
Term
| potassium sparing diuretics |
|
Definition
| spironolactone, eplerenone; triamterene, amiloride |
|
|
Term
|
Definition
| Spironolactone, eplerenone |
|
|
Term
| inhibits potassium directly |
|
Definition
|
|
Term
| do not work well alone in txt of HTN; caution use with ACEI; caution use in renal insufficiency; hyperkalemia, gynecomastia |
|
Definition
| Potassium Sparing Diuretics |
|
|
Term
| inhibits the conversion of angiotensin I to angiontensin II; blocks degradation of bradykinin |
|
Definition
|
|
Term
|
Definition
| stimulate the synthesis of vasodilating substances (prostaglandin E2 prostacyclin) |
|
|
Term
|
Definition
| renal protection in susceptible patients; prevents remodeling in post MI and HF patients |
|
|
Term
|
Definition
| cough; postural hypotension; hyperkalemia; rash; increase SCr; angioedema; metallic taste; pregnancy category X |
|
|
Term
| ACE Inhibitors counseling tips |
|
Definition
| start low and go slow; may notice dry hacking non productive cough; do not take if you are or plan on being pregnant |
|
|
Term
| directly blocks ATI receptor that mediates the effects of angiotensin II |
|
Definition
|
|
Term
|
Definition
| no bradykinin effects; work well in combo with diuretics |
|
|
Term
|
Definition
| less cough; less angioedema; low incidence of SE; use in DM, nephropathy, HF patients |
|
|
Term
|
Definition
| renal insufficiency, hyperkalemia, orthostatic hypotension, pregnancy category X, angioedema |
|
|
Term
| dose dependent reductions in plasma renin activity |
|
Definition
|
|
Term
|
Definition
|
|
Term
| inhibits conversion of angiotensinogen to angiotensin I; only one to decrease renin activity despite increase in renin concentrations |
|
Definition
| Direct Renin Inhibitors (Aliskiren) |
|
|
Term
| Aliskiren contraindication |
|
Definition
| use with an ACEI or ARB in patients with diabetes mellitus |
|
|
Term
|
Definition
| headache, dizziness diarrhea |
|
|
Term
|
Definition
| angioedema, hyperkalemia (in combo with ACEI) |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| blocking voltage-sensitive calcium channels |
|
Definition
|
|
Term
|
Definition
| relaxation of cardiac and smooth muscles --> vasodilation |
|
|
Term
| negative inotropic effects |
|
Definition
|
|
Term
|
Definition
| good for use in angina; alternative option for DM patients; Raynaud's syndrome |
|
|
Term
|
Definition
| bradycardia; AV block; heart failure; anorexia; nausea; peripheral edema; headache; hypotension; constipation; gingival hyperplasia |
|
|
Term
| decrease heart rate, decrease mortality, decrease renin output |
|
Definition
|
|
Term
| exhibit intrinsic sympathomimetic activity (ISA) |
|
Definition
| oxprenolol, pindolol, penbutolol, and acebutolol |
|
|
Term
| capable of exerting low level agonist activity at the beta adrenergic receptor while simultaneously acting as a receptor site antagonist; may be used in individuals exhibiting excessive bradycardia with sustained beta blocker therapy |
|
Definition
|
|
Term
|
Definition
| useful in arrhythmias; migraines, tremor; perioperatively; thyrotoxicosis; high renin states; anxiety; HF |
|
|
Term
|
Definition
| bradycardia, fatigue, dizziness, bronchial constriction, depression, decreased HDL, insomnia/nightmares, AV block, sexual dysfunction, increased PVD |
|
|
Term
| decreased perfusion --> increased serum creatinine |
|
Definition
|
|
Term
|
Definition
| taper rather than D/C abruptly; may be tired when you 1st start but it should god away; masks hypoglycemia symptoms except for sweating |
|
|
Term
|
Definition
|
|
Term
|
Definition
| not necessarily more effective for HTN, main effects at beta receptor alpha blocking adds to vasodilatory actions; labetolol useful in hypertensive crisis; do not increase lipids |
|
|
Term
|
Definition
| Prazosin, terazosin, doxazosin |
|
|
Term
| inhibits catecholamine uptake in smooth muscle cells --> vasodilation; not used a first line agent, used in patients with BPH and HTN |
|
Definition
|
|
Term
| alpha receptor blockers pros |
|
Definition
| prostatism ( " a symptom complex resulting from compression or obstruction of the urethra, due most commonly to nodular hyperplasia of the prostate." ) |
|
|
Term
| alpha receptor blockers cons |
|
Definition
| 1st dose syncope; postural hypotension; syncope; sodium and water retention; vivid dreams; depression |
|
|
Term
| Alpha Receptor Blockers Counseling Tips |
|
Definition
| take 1st dose in MD office if possible; caution with elderly; take at bedtime if experiencing SE; if taking it for BPH as well as HTN observe for any signs of decreased urine output/changes |
|
|
Term
|
Definition
|
|
Term
| stimulates alpha 2 receptor in brain-- reduces sympathetic outflow, increases vagal tone |
|
Definition
|
|
Term
| chronic use of centrally acting agents |
|
Definition
| sodium and water retention |
|
|
Term
| 2nd or 3rd line agent; patch dosage form is available |
|
Definition
|
|
Term
| primary use in HTN during pregnancy; side effects limit use |
|
Definition
|
|
Term
| centrally acting agents Pros |
|
Definition
| use in special populations |
|
|
Term
| centrally acting agents cons |
|
Definition
| rebound HTN if withdrawn too quickly; sedation; dry mouth; depression; blood dyscrasia; hemolytic anemia |
|
|
Term
|
Definition
|
|
Term
| direct arteriolar smooth muscle relaxation |
|
Definition
|
|
Term
| Use in African americans? lupus-like syndrome; dermatitis; drug fever; peripheral neuropathy; hepatitis; vascular headache |
|
Definition
|
|
Term
| hair growth; more potent; fluid overload; pericardial effusion; EKG changes; last line agent |
|
Definition
|
|
Term
| max sodium intake for managing hypertension |
|
Definition
|
|
Term
|
Definition
| reductions of 1000 mg/day sodium |
|
|
