14 - Hypertension

Question 1

BP assoc w/ lowest risk of stroke and CAD?

Answer 1

115/75

Question 2

every ___ mmHg increase in SBP doubles risk of stroke and CAD death

Answer 2

20

Question 3

MAP = (real eqn and estimation)

Answer 3

CO x SVR

2/3 DBP + 1/3 SBP

Question 4

cutoff for HTN and stage 2 HTN

Answer 4

HTN = 140/90

stage 2 = 160/100

Question 5

major causes of secondary HTN

Answer 5

renal artery stenosis
renal dz
BC pills
aldosteronism
pheo
coarctation of aorta

Question 6

for HTN pts, what is BP goal?

what about w/ diabetes?

Answer 6

normal HTN pt - <130/80

Question 7

isolated systolic HTN

Answer 7

2/3 of all HTN pts >65 yo

SBP is more important as a risk factor than DBP, so still should treat

Question 8

3 main complications of HTN

Answer 8

heart disease
HT crisis
target organ damage

Question 9

criteria for hypertensive crisis, and what is the main problem?

Answer 9

BP > 200/120

vascular damage

Question 10

examples of hypertensive emergencies

Answer 10

hypertensive encephalopathy
acute stroke
retinal hemorrahge / papilledema
acute pulm edema
acute MI
acute renal failure
acute aortic dissection

Question 11

4 main target organ damage examples from HTN

Answer 11

peripheral vascular disease
aortic aneurysm / dissection
nephrosclerosis leading to renal failure
thromboembolic or hemorrhagic stroke

Question 12

how much do meds and weight loss affect BP, respectively?

Answer 12

meds - 1 med usually drops it by 10/5 mmHg

2 lbs weight loss usually drops 1 mmHg off SBP

Question 13

initial drug choices for stage 1 and 2 HTN

Answer 13

stage 1 - thiazide diuretics (other options - ACEI, ARB, BB, CCB)
stage 2 - 2 drug combo for most usually thiazide diuretic + (ACEI, ARB, BB, or CCB)

Question 14

other compelling reasons to use different HTN meds than first line

Answer 14

heart problems - generally want to consider a BB

diabetes/kidney problems - ACEI/ARBs are a good choice