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Cardiovascular > Hypertension > Flashcards

Flashcards in Hypertension Deck (17)
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1

Start medications

- >60 years old with no CKD or DM
150/90
- <60 years old or any patient with CKD or DM
140/90

2

Start preventive treatment

>120/80

3

Strategies to dose antihypertensive medications

-start one drug, titrate to maximum dose, then add second drug if goal not achieved
-start one drug, then add second drug before achieving maximum dose of initial drug
-begin with 2 drugs either as two separate pills or as a single pull combination
-may consider #3 if SBP >160 mmHg or if DBP >100 mmHg usually with a diuretic

4

Causes of secondary hypertension

-intrinsic renal disease
-renovascular disease
-mineralocorticoid excess
-sleep disorders
-drug/alcohol induced

5

Pallor, edema physical findings

renal disease

6

Abdominal bruit physical finding

renovascular

7

Truncal obesity, purple striae, buffalo hump

hypercortisolism

8

RAAS system

-renin is normally produced in the kidneys in response to decreased intracellular volume
-angiotensin II is a potent vasoconstrictor
-aldosterone increases sodium and water reabsorption in the distal tubules

9

Criteria for Metabolic Syndrome

-obesity with a waist circumference of >40" in men and >35" in women
-BP >130 mmHg SBP and/or >85 mmHg DBP
-FBS >110 mg/dL
-Serum triglycerides >150 mg/dL
-HDL cholesterol <40 mg/dL in men, <50 mg/dL in women

10

>60 years old

treatment goal: systolic <150 mmHg, diastolic <90 mmHg

11

< 60 year old DBP

treatment goal: DBP <90 mmHg

12

<60 year old SBP

treatment goal: SBP <140 mmHg

13

>18 year old with CKD

treatment goal: SBP <140 mmHg, DBP <90 mmHg

14

>18 year old with diabetic mellitus

treatment goal: SBP <140 mmHg, DBP <90 mmHg

15

non-black population with or without DM treatment

meds include thiazide type diuretic, CCB, ACEI, ARB

16

black population with or without DM treatment

-thiazide type diuretic or CCB
-you can use ACE, ARB, or beta blockers but expect a reduced response
-2-4x risk of ACE induced angioedema compared to other groups

17

>18 year old with CKD treatment

includes ACEI or ARB