Hypertension

Question 1

Definition of normal blood pressure, prehypertension, and hypertension stage 1 and 2 based on JNC 7 guidelines

Answer 1

normal: < 120/80 prehypertension: 120-139 systolic, 80-89 diastolic hypertension stage 1: 140-159 systolic, 90-99 diastolic hypertension stage 2: >160 systolic, >100 diastolic

Question 2

Describe the prognostic significance of blood pressure as a cardiovascular risk factor in relation to age

Answer 2

systolic pressure is the greater predictor of risk in patients over the age of 50 to 60 years. Under age 50 years, diastolic blood pressure is a better predictor of mortality than systolic readings

Question 3

refers to specific pathophysiological changes that may be associated with marked hypertension, including retinal hemorrhages, exudates, or papilledema

Answer 3

Moderate to severe hypertensive retinopathy (formerly called “malignant hypertension”)

Question 4

indicative of retinal ischemia. The differential diagnosis includes diabetes, hypertension, AIDS, and the retinal vascular changes of systemic lupus erythematosus

Answer 4

cotton wool spots

Question 5

severe hypertension (usually a diastolic blood pressure above 120 mmHg) with evidence of acute end-organ damage

Answer 5

hypertensive emergency

Question 6

defined as a 20 mmHg or greater fall in systolic pressure upon rising from supine to an unassisted upright position

Answer 6

postural hypotension

Question 7

Which tests should be performed in all patients with newly diagnosed hypertension?

Answer 7

Electrolytes and serum creatinine (to calculate the estimated glomerular filtration rate), Fasting glucose, Urinalysis, Lipid profile (total and HDL-cholesterol, triglycerides), Electrocardiogram (ECG)