Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
| Cardiovascular Risk Factors |
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Definition
| HTN, Cigarette smoking, BMI >30kg/m2, Physical Inactivity, Dyslipidemia, DM, Microalbuminuria or GFR <60mL/min, >55 yo M or >65 yo F, Family HO of premature cardiovascular disease |
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Term
| When to start Lifestyle Modification |
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Definition
| Not at Goal BP (<140/90) or (<130/80 for patients with DM or CKD) |
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Term
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Definition
Weight Reduction (BMI 18.5-24.9)
DASH diet (fruits,veges, and lowfat dairy)
Physical Activity (30 min most days)
Moderation of EtOH (2 drinks for men, 1 drink for women)
Sodium Restriction (<2.4g) |
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Term
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Definition
| Blocking B1 in heart causes: decrease HR and contractility, decreased renin secretion, decreased sympathetic outflow from CNS, altered baroreceptor function, increased synthesis of prostacyclin in smooth muscle cells, increased release of NE |
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Term
| Angiotensin II receptor antagonist MOA |
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Definition
| Block AT1 receptors in a competitive, but essentially irreversible manner because of their high affinity for the slow dissociation from the receptor. |
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Term
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Definition
| Distal tubule, competes for Cl binding sites on the Na & Cl symporter, causes ions to remain in the tubule lumin to be excreted. Increase K bc increased Na present for Na/K exchange pump. Loose: Na/K/Cl/H2O/Mg/halogens, retain uric acid/Ca |
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Term
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Definition
| Function at Ascending Loop of Henle. Bind to Cl binding sites of the Na/Cl symporter to decrease the gradient. Less water is retained from the collecting duct, leading to more dilute urine. Loss Na/K/Cl/Mg/Ca/H2O, retain uric acid |
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Term
| K Sparing Diuretics MOA Type 1 |
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Definition
Aldosterone increases Na/H20 reabsorption and enhances K excretion. Compete with the binding site of aldosterone. Main site of action is the distal tubule and collecting ducts. Loose Na/Cl/H2O, retain K
Ex: Spironolactone and Eplerenone |
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Term
| K Sparing Diuretics MOA Type 2 |
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Definition
Late distal tubule and collecting ducts. Directly interfere with Na entry through the Na-selective ion channels in the collecting tubule. Loose Na/Cl/H2O, retain K
Ex: traimterene and amiloride |
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Term
| Intervals of r follow-up of BP based on initial measurements |
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Definition
Normal- 2 years
PreHTN- 1 year, lifestyle counseling
Stage 1- confirm in 2 months, lifestyle
Stage 2- confirm in 1 month, Refer if >180/110 or clinical symptoms |
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Term
| Goals for Uncomplicated HTN |
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Definition
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Term
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Definition
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Term
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Definition
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Term
| Goals for CAD or high CAD risk |
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Definition
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Term
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Definition
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Term
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Definition
| Na, K, Cl, CO2, BUN, SCr, glucose, BP |
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Term
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Definition
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Term
| Monitoring Aldosterone Receptor Blockers |
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Definition
| K, SCr, BP, questions about adverse effects, gynocomastia |
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Term
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Definition
| BP, HR, EKG, questions about adverse events |
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Term
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Definition
NDHP: BP, HR, EKG, AE
DHP: BP, physical assesment, AE |
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Term
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Definition
| K, SCr, physical assessment, AE |
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Term
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Definition
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Term
| How do AHA guidelines differ from JNC-7 |
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Definition
| BB should be used only with compelling indications such as angina, HF, post-MI. Not for uncomplicated HTN |
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Term
| Therapy in African Americans |
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Definition
Decreased response to BB, ACE-I, ARB
More responsive to Diuretics & CCB |
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Term
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Definition
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Term
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Definition
Stable Angina: BB or CCB
Unstable angina or post-MI: BB and ACE-I, then thiazide |
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Term
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Definition
Asymptomatic: ACE-I with BB if stable. Then thiazide
Symptomatic: ACE-I, BB, ARB, and aldosterone antagonists with loop diuretics. |
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Term
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Definition
Need ACE-I or ARB to reduce risk of renal failure (w/ verapamil or diltiazem if those cannot be tolerated).
ARB preferred over ACE-I for proteinurea patients. Use thiazide to make more effective. Use BB if CAD present |
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Term
| Appropriate tx in COPD/Asthma |
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Definition
BB, Alpha-Beta Blockers may worsen asthma.
Use ACE, if cough occurs ARB is alternative. OTC cough/cold remedies may raise bp temporarly. |
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Term
| Appropriate tx in dyslipidemia |
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Definition
High doses of thiazides/loops may increase TC, TG, LDL, but not normal doses.
BB may transiently increase TG and reduce HDL, but they are cardioprotective.
Alpha-blockers may decrease TC and increase HDL. ACE-I, ARB, CCA, central α2 agonists are lipid neutral. |
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Term
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Definition
elevated uric acid levels may reflect decrease in renal blood flow. Diuretics should be avoided in gout pts.
Diuretic induced hyperuricemia does not require treatment unless symptoms. |
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Term
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Definition
GFR below 60ml/min (SCr over 1.5), or albuminuria.
Goal is to slow deterioration of renal function and prevent CVD.
ACE-I or ARB recommended, NKF also recommends loop diuretic. Monitor SCr, K |
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Term
| Appropriate tx in LV hypertrophy |
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Definition
lean toward use of ACE-I.
No help from vasodilators |
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Term
| Appropriate tx in pregnancy |
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Definition
increased risk to mother and fetus.
Use methyldopa, BB, vasodilators. No renin-inhibitors, ACE-I or ARBs due to fetal risk |
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