Clinical Care- Hypertension

Question 1

Elevated Hypertension

Answer 1

SBP: 120-129, DBP <80

Question 2

Stage 1 Hypertension

Answer 2

S: 130-139, D: 80-89

Question 3

Stage II hypertension

Answer 3

S: 140>, D: >90

Question 4

Term when no single cause can be identified with hypertension

Answer 4

essential hypertension

Question 5

First line treatment for hypertension

Answer 5

hydrochlorothiazide (HCTZ)

12.5-25mg PO daily and can titrate to max 50mg daily.

Angiotensin Converting Enzyme Inhibitors (ACEi) (First Line)
e.g. Lisinopril (Prinivil, Zestril), Enalapril (Vasotec), Captopril
(Capoten.

5-10 mg daily and can titrate to a maximum of 40 mg
daily.

Angiotensin Receptor Blockers (ARBs)
Losartan (Cozaar): Initial dose 50mg daily, titrate up to max of 100 mg daily.

Calcium Channel Blockers (CCB), Diltiazem (Cardizem)
180 mg daily and titrate to max dose of 360 mg daily

Question 6

This medication can drop your BP but it is primarily used for BPH (enlarged prostate)

Answer 6

alpha blockers

Question 7

differentiating Hypertensive Urgency vs Hypertensive Emergency

Answer 7

NO SIGNS OF END ORGAN DAMAGE vs SIGNS OF END ORGAN DAMAGE

e.g. Intracranial hemorrhage, Unstable angina, AMI, CHF, or Aortic dissection, Ischemic stroke, Hypertensive encephalopathy (mental status changes, confusion, headache).

Question 8

Treatment of Hypertensive Emergency

Answer 8

IV, O2 if < 94%
Goal is to reduce BP by 25% within one to two hour
Labetalol 20 mg IV (over 10 minutes) then 40-80
mg IV q10 min PRN, max 300 mg.

After stabilization, Metoprolol 25-50 mg PO twice daily.