Flashcards in Intro & Hypertension Deck (41)
What are the systolic and diastolic numbers for hypertension?
140/90 or higher
What are the criteria for hypotension?
What % of "middle-aged (40-59) adults are hypertensive in the US?
Age 60 and over?
60+ = 66.7%
** Also more prevalent in African Americans
Describe essential hypertension
AKA primary hypertension
- no identifiable cause
- 90-95% of cases
- exacerbated by "bad habits"
Describe secondary hypertension
- cause can be identified
- suspected in patients under 20 and rapid increase in BP
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
What are the main organs of concern with hypertension?
End (target) organ damage to the:
If hypertension has led to a stroke what are the 4 things you should check first?
How would end organ damage to the kidneys present?
- blood test would show reduced glomerular filtration rate
- urine test would show proteinuria
How would end organ damage to the eyes present?
- retinal hemorrhage & retinal exudates
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
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)
What would an isolated systolic BP elevation indicate?
Increased risk of stroke/ MI
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
According to JNC 7 how when would you recheck a patient with normal BP?
1-2 years later
According to JNC 7 when would you recheck a pre-hypertensive patient's BP?
within 1 year & encourage patient to make life-style changes
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
What is the most accurate means of assessing BP?
Ambulatory BP monitoring
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
What are the JNC 8 treatment goals for patients with renal insufficiency or diabetes?
less than 80= 140/90 or lower
What are the JNC 8 treatment goals for patients over 80?
Regardless of comorbidities= 150/90 or lower
According to JNC 8 when do you check BP for a stage 1 hypertensive patient?
every 2-4 weeks.
What does ASCVD risk stand for?
AtheroSclerotic CardioVascular Disease Risk
According to the ASCVD risk estimator what is considered high for the 10 year risk?
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
What is Hypertensive "Crisis"?
SBP= >180 OR DBP >110
Is hypertensive crisis present a risk of acute or chronic damage to end organs?
White Coat hypertension accounts for ______% of stage 1 hypertensive patients?
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