Flashcards in Cardiovascular Deck (54)
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1
Isolated Systolic HTN
Elevated systolic with normal diastolic. Good predictor of CV events in the elderly. Vascular compromise.
2
Stage 1 HTN range
140-159 OR 90-99 mm Hg
3
HTN treatment goals for DM, kidney disease, and increased risk for stroke.
130/80 mm Hg
4
Lab tests for hypertension
urinalysis, blood glucose, hematocrit and lipid panel, serum potassium, creatinine, and calcium
5
Risk factors for cardiovascular disease
Hypertension
• Obesity
(body mass index >30 kg/m2)
• Dyslipidemia
• Diabetes mellitus
• Cigarette smoking
• Physical inactivity
• Microalbuminuria, estimated
glomerular filtration rate 55 for men, >65 for women)
• Family history of premature CVD
6
Identifiable causes of HTN
Sleep apnea
• Drug induced/related
• Chronic kidney disease
• Primary aldosteronism
• Renovascular disease
• Cushing’s syndrome or steroid
therapy
• Pheochromocytoma
• Coarctation of aorta
• Thyroid/parathyroid disease
7
Stage 1 Hypertension - treatment without compelling indications
Thiazide-type diuretics for most. May consider ACEI, ARB, BB, CCB, or combination
8
Stage 2 Hypertension - treatment without compelling indications
2-drug combination for most (usually thiazidetype diuretic and ACEI, or ARB, or BB, or CCB).
9
Compelling indication - Heart failure
THIAZ, BB, ACEI, ARB, ALDO ANT
10
Compelling indication - Post myocardial infarction
BB, ACEI, ALDO ANT
11
Compelling indication - High CVD risk
THIAZ, BB, ACEI, CCB
12
Compelling indication - Diabetes
THIAZ, BB, ACEI, ARB, CCB
13
Compelling indication - Chronic kidney disease
ACEI, ARB
14
Compelling indication - Recurrent stroke prevention
THIAZ, ACEI
15
Lifestyle modification for HTN
Components of lifestyle modifications include weight reduction, DASH eating plan, dietary sodium reduction, aerobic physical activity, and moderation of alcohol consumption.
16
Weight reduction drop in SBP
5-20
17
DASH diet drop in SBP
8-14
18
Sodium reduction drop in SBP
2-8
19
Exercise drop in SBP
4-9
20
Alcohol consumption limits (<2 drinks per day) drop in SBP
2-4
21
thiazide diuretics
suffix "ide" first line unless compelling indication not to use.
22
ACE inhibitor
suffix "pril" Use in high renin states and DM
23
ARB
suffix "sartan" Use in high renin states, DM, alternative to an ACE
24
Beta blockers
suffix "lol" Not for use in uncomplicated HTN but a god add on medication
25
Calcium channel blockers
suffix "dipine" Use for isolated systolic HTN
26
How long do you trial lifestyle modifications
3 months
27
Common side effect of HCTZ
erectile dysfunction
28
What medication should not be used with a calcium channel blocker?
HCTZ - no synergism
29
What medication should not be used in pregnancy?
ACE/ARB
30
