Hypertension

Question 1

How often should you screen for hypertension?

Answer 1

Roughly every 2 years, starting at the age of 3

Question 2

Define hypertension.

Answer 2

Persistent blood pressure great than 140/90 mmHg. Remember that 145/60 is hypertension, as is 115/95.

Question 3

What is the Joint National Committee Hypertension Classification of systolic BP <80?

Answer 3

Normal

Question 4

What is the Joint National Committee Hypertension Classification of systolic BP 120-139 or diastolic BP 80-89?

Answer 4

Prehypertension

Question 5

What is the Joint National Committee Hypertension Classification of systolic BP 140-159 or diastolic BP 90-99?

Answer 5

Stage I hypertension

Question 6

What is the Joint National Committee Hypertension Classification of systolic BP >160 or diastolic BP >100?

Answer 6

Stage II hypertension

Question 7

What is the 2-measurement rule in the diagnosis of hypertension?

Answer 7

BP should be measured two times on each of two separate office visits before diagnosis and treatment is started.

Question 8

What are the conservative (i.e. nonpharmacologic) treatment for hypertension?

Answer 8

Dietary changes (i.e. low salt, low fat, low calorie), reduced smoking and alcohol intake, weight loss, and exercise may each have a positive effect. For stage I hypertension is it reasonable to give a 1-2 month trial of lifestyle modifications before starting meds.

Question 9

What are the first-line medications for treatment of hypertension?

Answer 9

Thiazide-type diuretics should be used as initial therapy for most patients, either alone or in combination with one of the following: ACE inhibitors, ARBs, beta blockers, and calcium channel blockers.

Question 10

Thiazide diuretics should be used in patients with –? Avoided in patients with –?

Answer 10

Use for: heart failure, diabetes, high risk of CAD or stroke, osteoporosis
Avoid in: gout, electrolyte disturbances (e.g. hyponatremia), pregnancy

Question 11

Beta blockers should be used in patients with –? Avoided in patients with –?

Answer 11

Use for: stable angina, acute coronary syndrome/unstable angina, acute or prior MI, high risk for CAD, atrial tachycardia/fibrillation, thyrotoxicosis (short-term), essential tremor, migraines
Avoid in: asthma, COPD, heart block, sick sinus syndrome