HTN Flashcards
what is HTN (high blood pressure)
classification of BP in adults
normal <120/<80
elevated 120-129/<80
stage I HTN 130-139/80-89
Stage II HTN >140/>90
AHA defines HTN as
sustained SBP > 130 mmHg and DBP > 80 mmHg
HTN leads to an age related assocatiation to
ischemic heart disease, stroke, renal failure, retinopathy, PVD, and overall mortality
common risk for perioperative M&M shows ___ as a common risk factor if left untreated
HTN
in addition to SBP and DBP elevation, a widened pulse pressure is a risk factor for
CV remodeling as it correlates with vascular remodeling and stiffness
cause of primary HTN
SNS activity, dysregulation of RAAS, and deficency in endogenous vasodilators
genetic and lifestyle risk factors for HTN
obestity, alcholism and tobacco
secondary HTN causes in adults
hyperaldosteronism, thyroid dysfunction, OSA, Cushings, and pheochromocytoma
drugs that increase BP
secondary HTN causes for children birth to 12 years
coarction of aorta
renal parynchymal disease
secondary HTN in adolescence (12-18 years old)
coarction of aorta
secondary HTN causes of young adults
thyroid dysfunction
fibromuscular dyplasia
renal parychema
secondary causes of HTN in middle age adults (40-64)
hyperaldosteronism
cushing
pheo
OSA
thyroid dysfunction
secondary causes of HTN in older aldults >65 years
artherosclerotic renal artery stenosis
renal failure
hypothryoidism
chronic HTN leads to remodeling of
small and large arteries, endothelial dysfunction, and potentially irreversible end-organ damage
what can diagnose early vasculopathy
US of the common carotid intimal to medial thickness and arterial pulse wave velocity
cerebrovascular damage secondary to HTN
acute hypertensive encephalopathy
stroke
ICH
lacunar infarct
vascular dementia
retinopathy
heart disease secondary to HTN
LV hypertrophy
afib
coronary microangiopathy
CAD - MI
heart failure
neprhopathy secondary to HTN
albuminuria
proteinuria
chronic renal insufficency
renal failure
vasculopathy secondary to HTN
endothelial damage
remodeling
generalized atherosclerosis
arteriosclerotic stenosis
aortic aneursym
what is resistant HTN
above goal BP despite3+ antihypertensive drugs at max dose
usually increases a CCB, ACE-I or ARB, and diuretic
controlled resistant HTN
controlled BP requiring 4+ medications
refractory HTN
uncontrolled BP on 5+ drugs
psuedo-resistant HTN
intolerance to drugs can result from BP inaccuracies (white coat syndrome) and or medication noncompliance
lifestyle modifications to help manage HTN
weight loss, decrease ETOH, exercise, smoking cessation
T/F there is a continuous relationship between increased BMI and HTN
true! weight loss is an effective nonpharm intervention through direct BP reduction and syngergistic enhancement of drug efficacy
for every 1kg of weight loss what decrease in BP would there be
1 mmHg
excessive ETOH is associated with what and BP
increased HTN and resistance to antihypertensives
T/F dietary K+ and Ca++ intake are inversely related to HTN and cerebrovascualr disease
true
T/F salt restriction is not assocaited with small but consistent BP drops
false
According to ACC/AHA Guidelines
evidence supports treating which patients with BP meds if SBP > 130 mmHg
hint: theres 4
ischemic heart disease
cerebrovascular disease
CKD
artherosclerotic disease
According to ACC/AHA Guidelines
evidence supports treating which patients with nonpharm therapy if SBP > 130 mmHg or DBP>80
patients without CV or cerebrovascular disease
According to ACC/AHA Guidelines
effective antihypertensive medications for nonblack HTN patients
ACE-Is, ARBs, CCBS, thiazide diuretics
According to ACC/AHA Guidelines
in black patients with HTN without HF or CKD but including those with DM.. what is the initial therapy for HTN
CCB or thiazide diuretic
According to ACC/AHA Guidelines
antihypertensive therapy in those with CKD
ACE-Is, ARBs improve kidney outcomes
Beta blocker therapy is reserved for
patients with CAD or tachydysrhtymias
or multidrug treatment in resistant HTN
treatment for secondary HTN
surgical correction of renal stenosis, adrenal adenoma, pheochromocytoma
is renal artery repair is not possible BP management is through
ACE-Is alone or with a diuretic
when are ACE-I, ARBs, and direct renin inhibitors not recommended for renal artery stenosis
bilateral renal artery stenosis
as they accelerate renal failure