Hypertension

Question 1

The lifetime risk of developing hypertension is ______.

Answer 1

90%

Question 2

Starting at 115/75, risk of cardiovascular disease doubles with each _______ increase in blood pressure.

Answer 2

20/10

Question 3

For persons over the age of 50, _______ blood pressure is a better predictor of CVD risk (as shown by the _______ trial).

Answer 3

systolic; MRFIT

Question 4

Mean arterial pressure is proportional to _________.

Answer 4

CO x SVR

Question 5

In essential hypertension, 70% of those have __________.

Answer 5

idiopathic increases in SVR

Question 6

What is considered prehypertension?

Answer 6

SBP: 120 - 139
DBP: 80 - 89

Question 7

What is stage 1 hypertension?

Answer 7

SBP: 140 - 159
DBP: 90 - 99

Question 8

What is stage 2 hypertension?

Answer 8

SBP: greater than 160
DBP: greater than 100

Question 9

How many people in the United States have hypertension?

Answer 9

Slide says 50 - 60 million, Dr. Linas said 80 million

Question 10

Only about _______ of patients with hypertension meet criteria for being “controlled.”

Answer 10

1/3

Question 11

__________ blood pressure is more difficult to control.

Answer 11

Systolic

Question 12

Briefly describe the Guyton hypothesis of primary hypertension.

Answer 12

Guyton thought that primary hypertension results from an initial defect in sodium excretion which leads to water retention. Water retention leads to increased cardiac output, which then leads to autoregulatory vasoconstriction.

Question 13

What is the cellular hypothesis of essential hypertension?

Answer 13

Inhibition of the NaK exchanger leads to increased intracellular Na which then decreases the amount of calcium secreted. Increased intracellular Ca leads to increased smooth muscle tone, increasing systemic vascular resistance.

Question 14

The in-office method of measuring BP involves ____________.

Answer 14

two readings five minutes apart

Question 15

What is one of the new risk factors for hypertension that we learned in this lecture (nephrological)?

Answer 15

Microalbuminuria or eGFR less than 60 ml/min

Question 16

Achieving a sustained decrease of ________ will save one out of every eleven people over ten years.

Answer 16

12 mmHg

Question 17

________ blood pressure is more difficult to control.

Answer 17

Systolic

Question 18

A hypertension visit consists of assessing the patient’s BP, identifying causes, and determining if organ damage is present. What are some signs of organ damage to look for?

Answer 18

Cardiac: hypertrophy, failure, angina
Stroke
Renal failure
Retinopathy
Peripheral artery disease

Question 19

Why should BP be controlled in hypertension?

Answer 19

Lowers the risk of MI, stroke, and heart failure

Question 20

With compelling indications, both stage 1 hypertension and pre-hypertension should be treated. In pre-hypertension without indications, _______ are indicated. In stage 1 hypertension, _________ are indicated.

Answer 20

no drugs; thiazides and possibly others

Question 21

For stage 2 hypertension, a _____-drug combination is advised.

Answer 21

two

Question 22

What are BP goals?

Answer 22

Less than 140/90 for patients without complications; less than 130/80 for diabetic patients or patients with chronic kidney disease

Question 23

The fact that high blood pressure leads to early mortality was first noticed by _____________.

Answer 23

insurance companies

Question 24

Kidney transplant studies in rats demonstrated that __________.

Answer 24

rats without hypertension develop hypertension when given a kidney from a rat with hypertension