HTN Flashcards
Describe the classification of blood pressure under the new AHA guidelines.
Normotensive is less than 120/80, elevated is 120-129, Stage I is 130-139/80-89, Stage II is 140/90 or higher.
Explain the difference between masked hypertension and white coat hypertension.
Masked hypertension has normal office readings but higher readings at home, while white coat hypertension has higher office readings but normal readings at home.
What are the goals for blood pressure management for all patients?
The goal is to maintain blood pressure below 130/80 for all patients, regardless of age, race, or comorbidities.
Identify risk factors for primary hypertension.
Risk factors include obesity, lack of physical activity, high sodium intake, alcohol consumption, genetic predisposition, and childhood factors.
List some causes of secondary hypertension.
Causes include renal parenchymal disease, renovascular disease, primary aldosteronism, and obstructive sleep apnea.
What are the recommendations for physical activity to manage blood pressure?
Recommendations include 90 to 150 minutes of aerobic and/or dynamic resistance exercise per week and/or 3 sessions per week of isometric resistance exercises.
Explain the moderation of alcohol consumption in relation to blood pressure.
Moderation is advised, with 2 or fewer drinks daily for men and no more than 1 drink daily for women.
What substances should be limited or discontinued to manage blood pressure?
Limit or discontinue alcohol, amphetamines, antidepressants, antipsychotics, caffeine, decongestants, NSAIDs, oral contraceptives, and systemic corticosteroids.
What action should be taken if a patient’s ASCVD risk is less than 10%?
Start with healthy lifestyle recommendations and reassess in 3-6 months.
What should be done if a patient’s ASCVD risk is greater than 10% ?
Recommend lifestyle changes and initiate BP-lowering medication (1 medication); reassess in 1 month for effectiveness.
What should be considered if the treatment goal is not met after one month for Stage I hypertension?
Consider different medication or titration.
What is the recommended treatment for African American patients with hypertension?
Start with calcium channel blockers (CCB) or thiazides.
What combination of medications may be used if needed for African American patients?
Use CCB + thiazide, or CCB + thiazide + ACEI (or ARB) if needed.
What is the recommendation for patients requiring two medications for hypertension management?
Recommend healthy lifestyle changes and BP-lowering medication (2 medications of different classes).
What is the drug of choice for patients with osteoporosis and hypertension?
Thiazide or thiazide-like diuretics are the drug of choice in osteoporosis.
Identify the side effects associated with thiazide diuretics.
Side effects include photosensitivity, and caution is advised in patients with gout and diabetes mellitus.
What should be done for patients with a history of angioedema when switching from ACE inhibitors?
Patients with a history of angioedema with an ACE inhibitor can receive an ARB beginning 6 weeks after the ACE inhibitor is discontinued.
What precautions should be taken when prescribing beta-blockers to patients with asthma or COPD?
Avoid using non selective b-blocker ex propranolol
Explain the potential side effects of metoprolol and an alternative option.
Metoprolol may cause sexual dysfunction, so switching to atenolol, which has fewer side effects, is recommended.
What is the maximum daily dose for atenolol if symptoms persist at a lower dose?
If a patient is on atenolol 25 mg and symptoms still exist, the dose can be increased to the maximum daily dose of 100 mg.
Identify the only beta-blocker used in erectile dysfunction and its mechanism.
Nebivolol is the only beta-blocker used in erectile dysfunction as it is a nitric oxide producer.
Describe a common side effect of CCBs in patients.
Edema or pedal edema is (occurring more frequently in women than in men.)
Explain the safety of antihypertensive medications during pregnancy.
Most antihypertensive medications, except for ACE inhibitors, ARBs, and aliskiren, can be safely continued during pregnancy.
List second-line antihypertensive drugs that are considered safe for pregnant women.
Methyldopa (Aldomet) , nifdpine(adalat) and Hydralazine.
