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Flashcards in Intro & Hypertension Deck (41)
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1

What are the systolic and diastolic numbers for hypertension?

140/90 or higher

2

What are the criteria for hypotension?

Systolic BP

3

What % of "middle-aged (40-59) adults are hypertensive in the US?
Age 60 and over?

Middle-aged- 30.4%
60+ = 66.7%

** Also more prevalent in African Americans

4

Describe essential hypertension

AKA primary hypertension
- no identifiable cause
- 90-95% of cases
- exacerbated by "bad habits"

5

Describe secondary hypertension

- cause can be identified
- suspected in patients under 20 and rapid increase in BP

6

What are some causes to consider for secondary hypertension?

- obstructive sleep apnea
- medication induced or drug-related
- kidney or renal-vascular disease
- hormonal abnormalities
- cushings, aldosteronism, pheochromacytoma, thyroid or parathyroid disease
- coarctation of the aorta

7

What are the main organs of concern with hypertension?

End (target) organ damage to the:
- heart
- brain
- kidneys
- eyes

8

If hypertension has led to a stroke what are the 4 things you should check first?

-Face
-Arm
-Speech
-Time

9

How would end organ damage to the kidneys present?

Renal failure
- blood test would show reduced glomerular filtration rate
- urine test would show proteinuria

10

How would end organ damage to the eyes present?

Retinal damage
- retinal hemorrhage & retinal exudates
- papilledema

11

According to UWS who needs their BP checked?

- All new patients
- Patients already known to have elevated BP
- any patients not seen in over a year

12

What are the criteria to diagnose hypertension?

- average of 2 or more reading over 2 or more visits
- check BP in both arms, use higher BP of the two arms
- use higher category to classify (systolic vs. diastolic)

13

What would an isolated systolic BP elevation indicate?

Increased risk of stroke/ MI

14

According to JNC 7 Hypertension Guidelines what BP is normal? pre-hypertension? stage 1? stage 2?

- Normal= 120/80
- Pre-hypertension= 120-139/ 80-89
- Stage 1= 140/159/ 90-99
- Stage 2= >160/ >100

15

According to JNC 7 how when would you recheck a patient with normal BP?

1-2 years later

16

According to JNC 7 when would you recheck a pre-hypertensive patient's BP?

within 1 year & encourage patient to make life-style changes

17

According to JNC 7 when would you confirm a stage 1 patient's BP

Confirm within 2 months
- consider home/ambulatory monitoring to confirm
- recommend lifestyle changes & non-pharm treatment

18

What is the most accurate means of assessing BP?

Ambulatory BP monitoring

19

What are the JNC 8 treatment goals for patients that DO NOT have diabetes mellitus or renal disease?

- less than 60 = 140/90 or lower
- over 60 = 150/90 or lower

20

What are the JNC 8 treatment goals for patients with renal insufficiency or diabetes?

less than 80= 140/90 or lower

21

What are the JNC 8 treatment goals for patients over 80?

Regardless of comorbidities= 150/90 or lower

22

According to JNC 8 when do you check BP for a stage 1 hypertensive patient?

every 2-4 weeks.

23

What does ASCVD risk stand for?

AtheroSclerotic CardioVascular Disease Risk

24

According to the ASCVD risk estimator what is considered high for the 10 year risk?

> 7.5%

25

According to JNC 7, what are the guidelines of action for a stage 2 hypertensive patient's treatment?

Confirm within 1 month
Refer for pharmacological treatment & lifestyle changes

26

What is Hypertensive "Crisis"?

SBP= >180 OR DBP >110

27

Is hypertensive crisis present a risk of acute or chronic damage to end organs?

Acute

28

White Coat hypertension accounts for ______% of stage 1 hypertensive patients?

15-20%

29

If you come across a hypertensive "crisis" what are the 3 steps of action?

- recheck & if still >180/110, assess for symptoms of target organ damage (TOD)
- if symptoms- refer to emergency department for further evaluation
- if no symptoms- refer to PCP urgently- patient needs BP lowering medication immediately

30

What are the symptoms of end organ damage for the 4 main target organs or hypertension?

Heart= chest pain or dyspnea (difficulty breathing)
Brain= Confusion, neurologic deficits
Kidneys= decreased urine output
Eyes= vision changes (blurry)