htn Flashcards
(64 cards)
hypertension more common in ___ and ____ pts
hint **race, and gender
male, and black
more severe among black patients
pathogenesis of htn?
bp reacts to change in enviornemnt
primary factors= RAAS, and sympathetic nervous system
multifactorial, not well understood
risk factors for primary hypertension
age
obesity
family history
race
high sodium
physical inactivity
excess alcohol
secondary HTN is __ causes such as
specific,
meds, nsaids
renal artery stenosis
illicit drugs such as meth or cocaine
aldosteronism
obstructive sleep apnea
what is renal artery stenosis and who is it seen in
older pt with hypertension
young adult women with fibromuscular dysplasia
when to suspect secondary hypertension cause
resistant to three or more drugs
family history
less than 30 years old
renal artery stenosis signs
epigastric or renal artery bruits
severe htn in pt over 55
increase in serum creatinine, at least 50% after administering ace or arb, do to reduced blood flow to the area
diagnosis of renal artery stenosis
renal angiography
renal artery stenosis tx
ace or arb
if recurrent flash pulmonary edema, or intolerant to medical therapy should consider revascularization
htn is risk factors for what complication
coronary artery disease
aortic dissection
aortic abdominal aneurysm
heart failure
left ventricular hypertrophy
STROKE** (ischemic and hemorrhagic)
kidney disease, can be a cause and/or target
atherosclerotic disease
hypertension is the most common AND IMPORTANT risk fatcopr for what?
ischemic and hemorrhagic stroke
secondary cause of aldosteronism; triad, lab work, and treatment
hypertension usually >150/100, hypokalemia and alkalosis
need to check plasma aldosterone concentration
PAC ratio: PRC is positive
can either be Surgical or medical
- excision
spironolactone, and low salt
what is primary aldosteronism and why is it a secondary cause of hypertension
increase in aldosterone leads to increase in sodium retention
cushings as a cause of secondary htn features
lab work
obesity, easy bruising, lethargy, moon face,
24 hour cortisol excretion
low dose dexamethasone suppressipn test
most patient with htn die from complications of _______
atherosclerosis
in preparation for taking a blood pressure reading what will you do prior?
make sure patient has emptied bladder first*
have the patient relax in a sitting or lying position for at least 5 minutes before
patient should avoid caffeine or alcohol for at least 30 minutes before
checking blood pressure reading for the first office properly requires checking only 1 arm, true or false?
false,
must check 2 arms
use the arm with the higher reading for subsequent blood pressure reading
on first visit with your patient how will you check blood pressure?
will check blood pressure in both arms
will use arm with higher reading for subsequent reading
wait 1-2 minutes between readings
in auscultating bp, the first (1st) korotkoff sound is the _____ bp whereas the diassapearence of korotkoff sounds is the ______ bp
systolic bp
diastolic bp
to estimate level of bp you will average readings use an estimate of ____ bp and on ____ occasions
2 or more blood pressure reading
on
2 or more occasions
preferred method to confirm diagnosis of htn
at home, interval
15- 20 mins daytime intervals
30-60 minutes during night/sleep
measuring at home bp best to assess for _______syndrome
white coat
most common symptom in pts with hypertension,
headache
most patients are asymptomatic
best way to diagnose htn is through _____ bp reading
multiple
>2 readings on >2 occasions
