HTN

Question 1

What is the goal of HTN therapy?

Answer 1

To lower systolic BP

Question 2

2 definitions of HTN:

Answer 2

Equal to or Over 140 SBP
Equal to or over 90 DBP
Taking anti-HTN meds

Question 3

What is normal BP?

Answer 3

Less than 120/80

Question 4

What is prehypertension?

Answer 4

120-139 SBP

Or

80-89 DBP

Question 5

What values are considered HTN? (2 stages)

Answer 5

Stage 1:
140 OR 90-99 for 18-79 yo 18-59
150-159 OR 90-99 for over 80 or 60

Stage 2: over 160 SBP
Over 100 DBP

Question 6

Primary/essential HTN versus secondary HTN?

Answer 6

Primary: idiopathic(don’t know cause)- many lifestyle factors
Tx = managed by lifestyle/meds

Secondary: caused by medical condition.
It is reversible with Tx

Question 7

What pathway and specific enzyme is main regulator of BP (long term) ?

Answer 7

Renin-angiotensin-aldosterone system and the angiotensin II is the protein

Question 8

What pathway and factors are a short term change in BP?

Answer 8

(MAP) mean arterial blood pressure changed by stroke volume and heart rate.

Question 9

What is the most important risk factor for strokes?

Answer 9

HTN

Question 10

What is the foundational HTN Tx r/t MNT?

Answer 10

Prescribing the DASH diet.

Question 11

What does the DASH diet emphasize?

Answer 11

8-9 F/V servings per day 
3 low-fat dairy per day
Less than 5 sweets per week
Little meat and alcohol 
Fish, poultry, nuts

Question 12

What mineral/electrolytes does DASH focus on?

Answer 12

Lower Na
Higher Ca
Higher K
Higher Mg

Question 13

What are 3 main outcomes of following DASH correctly?

Answer 13

Lower LDL
Lower HTN (systolic)
Lose weight

Question 14

What is the Na recommendation for all HTN patients?

Answer 14

2000-3000mg per day

Avg American is 3000-4500 per day

Question 15

What does DG for Americans suggest for Na? Who needs to further reduce this level and to what?

Answer 15

Less than 2300mg

1500mg for 51+yo, black, HTN, CKD, DM (50% of Americans)

Question 16

What does the AHA recommend for Na?

Answer 16

1500mg for everyone

Question 17

What is the AI for Na?

What is the amount of Na DASH allows?

Answer 17

1500 mg

2400mg

Question 18

What does the ATP IV recommend for Na?

Answer 18

2400mg
1500mg is desirable
Goal- reduce intake by 1000 mg

Question 19

Food guidelines for staying in a 4-g Na diet? 2-gram Na diet?

Answer 19

Each food less than 300mg per serving

Each food less than 200mg per serving

Question 20

Values for:
Sodium/salt free foods
Low sodium foods
Light in sodium foods

Answer 20

Less than 5mg per serving

Equal or less than 140mg per serving

50% less Na than regular version

Question 21

Values for:
Very low sodium foods
Reduced or less sodium foods
No salt added foods

Answer 21

Less than 35mg per serving

At least 25% less sodium than ref version

No salt added during processing

Question 22

Ingredients that indicate higher sodium levels?

Answer 22

Baking soda or powder
Brine 
MSG 
Sodium benzoate 
Disodium phosphate

Question 23

Examples of high sodium foods:

Answer 23

Ham
Canned tuna
Canned beans 
Processed cheeses (some natural) 
Canned tomato juice or sauce 
RTE cereals

Question 24

Examples of low sodium foods:

Answer 24

Fresh meat, fish, poultry 
Dried or frozen beans 
Fruit 
Cooked cereal, rice, pasta 
Vegetables (not canned)

Question 25

Which 2 diuretics cause loss of potassium (possible increase in BP)?

Answer 25

TcDZ and Lasix (furosemides)

Question 26

High BP is correlated with ___K, ___Ca, and ___Na?

Answer 26

Low K Low Ca High Na

Question 27

What is the goal for everyone under 60 with HTN? How about over 60?

Answer 27

Less than 140/90. Less than 150/90.

Question 28

What are the initial drug Tx choices?

Answer 28

CCB (blacks) Thiazide- diuretic (blacks) ACEI ARB

Question 29

HTN Tx: Diuretics What? 2 kinda?

Answer 29

Excrete K, Na, and urine so lower BP Furosemide and thiazide (chlorothiazide)

Question 30

HTN Tx: ACE Inhibitors 2 names? What?

Answer 30

"Pril" Captopril and enalapril Stop angio -II production so vasodilators.

Question 31

HTN Tx: Beta blockers 3 names? What?

Answer 31

"Olol" Atenolol, metoprolol,propanolol Block receptors in heart so decrease HR and decreased Q

Question 32

HTN Tx: Calcium channel blockers 3 names? What?

Answer 32

Nisoldipine, nifedipine, dilitiazem Cause blood vessel relaxation and decrease constriction.

Question 33

HYN Tx: Aldosterone antagonists Name? What?

Answer 33

"Actone" Spironolactone K sparing, increase water and Na excretion by blocking aldosterone

Question 34

HTN Tx: Angiotensin II receptor blockers 3 names? What?

Answer 34

ARBs= sartan Eprosartan, telmisartan, valsartan Stops RAAS from working. Less aldosterone, cardiac response, vasoconstriction, vasopressin. (All less)

Question 35

DASH: Daily servings of grains?

Answer 35

7-8 oz servings per day Slice of bread, 1/2 cup most cooked cereals

Question 36

DASH: Daily servings of vegetables?

Answer 36

4-5 servings per day 1 cup Raw leafy greens 1/2 cooked 6oz veggie juice

Question 37

DASH: Daily servings of fruit?

Answer 37

4-5 servings daily. 6 oz juice 1/4 cup dried 1/2 cup fresh, fr, canned

Question 38

DASH: Daily servings of low- fat dairy?

Answer 38

2-3 servings per day 1 cup yogurt or milk 1 1/2 oz cheese

Question 39

DASH: Servings of meat/poultry/fish

Answer 39

2 or less servings 3oz cooked meat, fish, poultry

Question 40

DASH: Servings of nuts, seeds, dried beans per week

Answer 40

4-5 servings per week 1 1/2 oz nuts (1/3 cup) 2 Tbsp or 1/2 oz seeds 1/2 cooked beans

Question 41

DASH: Servings of fats per day

Answer 41

2-3 fat servings per day 1 tsp soft margarine or veg oil 1 Tbsp lowfat mayo 2 Tbsp light dressing

Question 42

DASH: Servings of sweets per week

Answer 42

5 per week 1 Tbsp sugar/jelly or jam 1/2 oz jelly beans 8oz lemonade

Question 43

Foods high in K?

Answer 43

Potato, tomato, broccoli, sweet potato, fruits, dairy, avocado