Hypertension Flashcards
(31 cards)
Hypertension
- systolic: ≥ 130
- diastolic: ≥ 80
Elevated BP
120-129 (sys) and <80 (dia)
Stage 1 HTN
130-139 or 80-89
Stage 2 HTN
≥140 or ≥90
Isolated systolic HTN
> 130 and < 80
-common in >50 yrs
Primary HTN
- stress & increased SNS
- insulin resistance & hyperinsulinemia
- endothelial cell dysfunction
- altered renin-angiotensin
Primary causes
- environmental/demographic/genetic
- water & sodium retension
Age Risks for primary
- > 50 yrs old SBP more vital (CVD)
- normotensive at 55
Secondary HTN
elevated BP with a specific cause
HTN Manifestations
- mostly asymptomatic
- fatigue
- dizziness
- palpitations, angina
- dyspnea
HTN complications
- heart disease
- cerebrovascular disease
- peripheral vascular disease
- nephrosclerosis
- retinal damage
HTN Diagnostics
- urinalysis & uric acid
- ECG
- basic metabolic panel
- CBC
- lipid profile
HTN Lifestyle modifications
- weight loss of 10 kg (22 lb)
- diet rich in veggies, fruit, & nonfat dairy
- <2.3 g of sodium/day
- decrease alcohol (men: 2, women: 1)
- aerobic exercise 30 min
First Line Meds for HTN
- thiazide diuretics
- ACE inhibitors
- ARBs
- calcium channel blockers
Second Line
- loop diuretics
- beta blockers
- alpha 1 blockers
Bumetanide (Bumex)
- loop diuretic
- watch for orthostatic hyptension, dizziness, GI upset
Calcium Channel Blockers
- Very (verapamil) Nice (nifedipine) Drugs (diriazem)
- decrease contractility/conductivity/demand for oxygen
- don’t take with grapefruit
- SE: bradycardia
Ace Inhibitors
- ends with pril
- decrease peripheral vascular
- SE: dizziness, orhtostatic hypotension, first dose syncope
Alpha Blockers
- cardura (blocker), catapres, & aldomet (antagonists)
- SE: orthostatic, vertigo, palpitastions, sexual dysfunction
Beta Blockers
- B1: heart, B2: lungs
- decrease HR/force of contraction/A-V conduction
- inderal, tenormin, lopressor
- SE: bradycardia, hypotension, CHF, lethargy
Nitroglycerin
- vasodilator
- SE: hypotension, tachycardia, dizziness
Older Adults
- white coat HTN
- auscultatory gap
- orthostatic hypo
Hypertensive Crisis
- > 140 DPB
- in patients with history of HTN
- leads to: encephalopathy, ARF, MI, & heart failure
Crisis Care
- IV drug therapy: titrated to mean arterial pressure
- monitor cardiac/renal function
- neuro checks
- determine cause
- education