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Therapeutics 2 - Exam 5 > HTN 1 - olenik > Flashcards

HTN 1 - olenik Flashcards

(53 cards)

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1
Q

what is the most significant risk factor for CVD?

A

HTN

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2
Q

what are the long term consequences of HTN?

A

left ventricular hypertrophy
angina
MI
coronary revascularization
HF
stroke or TIA
CKD
peripheral vascular disease
retinopathy

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3
Q

what is essential HTN?

A

elevated arterial BP with an unknown etiology

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4
Q

what is secondary HTN?

A

elevated arterial BP due to concurrent medical conditions or medications
identifiable cause

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5
Q

what is isolated systolic HTN?

A

systolic BP values are elevated
diastolic BP values are not

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6
Q

what is resistant HTN?

A

fail to attain goal BP while adherent to regimen that includes at least 3 agents at max dose (including a diuretic) or when 4+ agents are needed

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7
Q

what is orthostatic hypOtension?

A

a systolic Bp decrease of over 20 mmHg
a diastolic BP decrease of over 10 mmHg within 3 minutes of position change
AND/OR
an increase in heart rate over 20 BPM

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8
Q

what is the pathophysiology of essential HTN?

A

humoral abnormalities
neuronal mechanisms
vascular endothelial mechanisms
peripheral auto regulation defects
electrolyte distrubances

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9
Q

how should blood pressure be solved?

A

CO x TPR

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10
Q

how should cardiac output be solved?

A

HR x SV

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11
Q

what are modifiable HTN risk factors?

A

high sodium intake
obesity
low potassium intake
excessive alcohol intake

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12
Q

what are non-modifiable HTN risk factors?

A

age
ethnicity
genetic predisposition
gender

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13
Q

how does age and gender correlate to risk factors of HTN?

A

under 55: male > female
55-64: female > male
over 64: female&raquo_space; male

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14
Q

why do females have a higher risk factor of HTN as they age?

A

during menopause, females lose the hormones that help control it better

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15
Q

what are substances that can increase BP?

A

illicit drugs
caffeine
nicotine
decongestants
amphetamines
antidepressants
atypical antipsychotics
immunosuppressants
OCs
NSAIDs
systemic steroids
oncology agents

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16
Q

what are the types of BP measurement techniques?

A

in-office
ambulatory BP monitoring (ABPM)
home BP monitoring (HBPM)

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17
Q

how should in-office BP readings be taken?

A

two readings 5 minutes apart with the patient sitting in a chair
confirmed elevated reading in opposite arm

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18
Q

what are the indications of ambulatory BP monitoring?

A

white coat and masked HTN
nighttime BP dipping

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19
Q

what are the indication of home BP monitoring?

A

white-coat and masked HTN
to evaluate the response to therapy
to improve adherence

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20
Q

how is normotensive classified in each setting?

A

no HTN in all

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21
Q

how is sustained HTN classified in each setting?

A

HTN in both

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22
Q

how is masked HTN classified in each setting?

Study These Flashcards
A

office/clinic/healthcare –> no HTN
home –> HTN

23
Q

how is white coat HTN classified in each setting?

Study These Flashcards
A

office/clinic/healthcare –> HTN
home –> no HTN

24
Q

what are benefits of HBPM and ABPM?

Study These Flashcards
A

confirm diagnosis
aide in medication titration
identify white coat and masked HTN
better predictor of long-term CV outcomes

25
what are the cons of HBPM and ABPM?
user error equipment cost insurance reimbursement
26
what is normal BP?
under 120/80
27
what is elevated BP?
120-129 / under 80
28
what is HTN stage 1?
130-139 / 80-90
29
what is HTN stage 2?
+140 / +90
30
how should normal BP be treated?
promote a healthy lifestyle reassess BP in 1 year
31
how should elevated BP be treated?
recommend non-pharm tx reassess BP in 3-6 months
32
how should HTN stage 1 be treated?
pt has ASCVD risk >10% or specific comorbidity --> use non-pharm, a medication, and reassess BP in 1 month none --> nonpharm with reassess BP in 3-6 months
33
how should HTN stage 2 be treated?
non-pharm interventions and 2 meds reassess BP in 1 month
34
what is BP threshold for most treatment initation?
130/80
35
what is BP threshold for secondary stroke prevention or no clinical CVD and 10 year ASCVD risk under 10%?
140 / 90
36
what is goals of treatment for HTN?
decrease morbidity/mortality reach BP targets select agents with proven CV benefit
37
what is the BP goals per ACC/AHA guidelines?
under 130/80 but under 140/90 for elderly
38
why is the BP goal for elderly less strict?
high comorbidity burden limited life expectancy greater chance of a hypoglycemia risk and fall risk
39
what is BP goal per KDIGO guidelines?
SBP under 120 for adults with elevated BP and CKD
40
what were the outcomes of the SPRINT trial?
intensive treatment group had 25% lower risk of primary CV composite outcomes 27% reduced risk of death 2.8 meds required on average increased risk of electrolyte abnormalities, hypotension, and AKI
41
what are the outcomes of the ACCORD trial?
intensive treatment group had no benefit in primary composite outcome 41% reduced risk of stroke increased risk of AE
42
how does weight loss decrease SBP?
by 5 mmHg
43
how does the DASH diet decrease SBP?
by 11 mmHg
44
how does decreasing sodium intake decrease SBP?
by 5 to 6 mmHg
45
what is the recommend sodium intake levels?
under 1500 mg/day or 1000mg reduction per day
46
how does enhancing potassium intake decrease SBP?
by 4 to 5 mmHG
47
what is the recommended potassium intake per day?
3500 to 5000 mg
48
how does physical activity impact SBP?
decrease by 4 to 8 mmHg
49
how does moderate alcohol intake impact SBP?
decrease by 4 mmHg
50
what is the recommended alcohol intake?
2 for men 1 for women
51
what foods are apart of the DASH diet?
vegetables fruits whole grains fat-free or low-fat dairy products fish poultry beans nuts and vegetable oils foods rich in K, Ca, Mg, fiber, protein, and lower in sodium (1500mg/day)
52
what foods should be limited while on DASH diet?
high in saturated fats (fatty meals, full-fat dairy products, tropical oils) sugar-sweetened beverages and sweets
53
what is pharm treatment options for HTN?
ACEi ARBs CCB direct renin inhibitors beta blockers diuretics alpha-1 blockers central alpha-2 agonists vasodilators

Therapeutics 2 - Exam 5 (14 decks)

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