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