hypertension Flashcards
describe hypertensive urgency
- SBP > 180 mmHg or a DBP >120 mmHg
- NO associated acute end organ damage of CNS, CV or kidneys
- BP must be reduced over hours to days
describe hypertensive emergency
- markedly elevated BPs
- Presence of acute end organ damage, often the result of the acute rise in BP
–> Eye, kidney, brain, etc
- requires IMMEDIATE therapy to reduce BP within minutes to hours to prevent further morbidity and mortality
describe Resistant hypertension
- BLOOD PRESSURE that is uncontrolled despite the use of three or more antihypertensive drugs
–> ideally taken at optimal dosease, and of which one is a diuretic
- Secondary causesa re more common in the subset of patients with RHTN than in the general hypertensive population
describe teh general risk factors for Resistant HTN (RHTN)
- older age, obesity
- chronic kidney disease (CKD)
- diabetes
- Obstructive sleep apnea
- consumption of high-salt diet
- african american race
- female gender
what are the major non-pharmacological lifestyle modifications
- reduce weight
- adopt DASH eating plan
- lower sodium intake
- physical acitivty
- Moderation of alcohol consumption (J curve effect)
describe baroreceptor reflex in hypertension
- chronic hypertension “RESETS” the baroreflex such that the increased pressure is considered normal
- With each antihypertensive agent, one must consider the effects on the baroreflex
–> attempts to lower the pressure activates reflex mechanisms that act to raise pressure
drugs to tx HTN In diabetes
- ACEI or ARB
drugs to TX HTN in pts with chronic kidney disease
ACEI or ARB
drugs to TX HTN in pts with coronary artery disease
ACEI or ARB
and Beta-Blocker
drugs to TX HTN in pts with Left ventricular dysfunction
Diuretics
ACEI or ARB and B-Blockers
Drugs to TX HTN in pts with previous ischemic stroke
ACEI with or without thiazide diuretic
review renin-angiotension-aldosertone system
describe therapeutic targets in the RAA system for HTN
