Hypertension Flashcards
(97 cards)
Normal blood pressure is defined as a systolic pressure of ________
AND a diastolic of _______.
Less than 120/80 (both numbers need to be lower)
Pre-hypertension is systolic ____to____
OR diastolic ____ to _____
Systolic: 120-139
Diastolic: 80-89
Stage 1 Hypertension is systolic ___to____
OR diastolic ___ to____
Systolic: 140-159
Diastolic: 90-99
Stage 2 hypertension is systolic _____
OR diastolic _____
Systolic: 160+
Diastolic: 100+
What is primary/essential HTN?
HTN that is due to multiple factors combining to raise BP
95% of all hypertension is essential HTN
What are the risk factors for Primary HTN?
There are 11 just look at the list
55yo + 👵🏿
Black 👩🏾🦱
Family history
Smoker 🚬
High salt diet🧂
Drinks a lot 🍸
Obese 🐽
Physical inactivity 🛋
Dyslipidemia 🥓
Personality traits (Type A, asshole, etc)
Vitamin D deficiency 🌞
What is secondary hypertension?
HTN resulting from an identifiable medication or medical condition
(You can have primary and secondary HTN going on at the same time. You should consider that your patient may have secondary HTN if they’re not responding to the tx you give them)
What are some of the possible causes of secondary HTN?
Renal disease
Renovascular disease
Medication (NSAIDS, estrogen, steroids)
Thyroid disease
Coarctation of the Aorta
Primary Hyperaldosteronism
Cushing‘s syndrome
Pheochromocytoma
Obstructive Sleep Apnea
What else is in the triad of primary hyperaldosteronism?
Hypokalemia
Metabolic acidosis
What is the triad of pheochromocytoma?
Headache
Sweating
Tachycardia
If your pts BP is elevated in the office, what should you do before you confirm their diagnosis of HTN?
Out of office blood pressure measurement
What is the gold standard for out-of-office BP measurement?
Ambulatory Blood Pressure Monitoring
(It’s the BP cuff you wear around for a few days. Good because it avoids white coat HTN, masked HTN, and lets you see nocturnal BP readings, which are better predictors anyways)
What are some of the general principles of obtaining a BP measurement?
Serial measurements are required
Measure on both arms
Comfortable setting
Avoid smoking, eating, exercising, and caffeine before taking your BP
What is better when checking BP in office: automated machine or manual BP?
Automated machine
Less likely to cause anxiety for the pt
What are some signs of end organ damage?
Heart failure
Renal failure
Stroke/CVA
Dementia
Aortic dissection
Retinopathy (vision changes)
What will you see on a fundoscopic exam of someone with MODERATE hypertensive retinopathy?
What else will you see if they have SEVERE hypertensive retinopathy?
Moderate: hard exudates, cotton wool spots, copper wiring, hemorrhaging, AV nicking
Severe: all of the above PLUS edema
What tests do you need to order when you’re thinking your pt has primary HTN?
Lipid Profiile Urinalysis Creatinine Blood Glucose Electrolytes EKG
(LUCBEE)
(Creatanine, Glucose and electrolytes are all a basic metabolic panel)
What is the best available method to monitor BP?
ambulatory BP monitoring
Does diagnosing HTN require multiple BP readings over time?
Yes
What kinds of questions should you be asking about when you take your pt’s history?
Identifying risk factors
Identifying secondary etiologies
What kinds of things should you be looking for in your exam of the pt with HTN?
Signs of end-organ damage
Secondary etiologies
What is the FIRST line treatment for ALL patients with essential HTN?
Lifestyle modifications:
Diet
Exercise
Weight management
Stop smoking
How much sodium should people be eating?
Ideally less than 1.5 g/day
What is the maximum amount of alcohol pts should drink
1-2/day for men
1/day for women
