Lecture 11 Hypertension Flashcards
(26 cards)
HTN is defined as persistent systolic BP over _____ and/or diastolic over _____
140, 90
HTN urgency is defined as systolic greater than _____ and or diastoloic greater than _____. with or without end organ damage?
180, 120;
without
HTN emergency is defined as systolic greater than ____ and diastolic greater than _____. with or without end organ damage?
180, 120;
with
most common cause of HTN?
idiopathic/primary/essential
equation for MAP?
CO * TPR
CO and TPR:
which is dependent on myocardial contractility and preload?
which is determined by tone of the arterioles?
which is typically elevated in patients with HTN?
CO,
TPR,
TPR
3 instances that typically cause a release of renin:
- _______ sensed by macula densa cells
- _____ sensed by juxtaglomerular cells
where is it released from?
- decreased Na delivery
- decreased BP
- increased sympathetic tone (via B1 receptors)
Juxta glomerular cells
generally, the RAAS system causes a _____ in blood pressure via increased _____ activity and retention of ____ and _____
increase;
adrenergic
H2O, Na
most patients have ____ levels of Renin
“inappropriately normal”
ie normal levels, but should not be normal due to high bp
_____ nephron mass causes HTN
reduced
secondary HTN: renal =
usual cause in males _____
classic cause in females _____
athersclerosis (renal stenosis)
fibromuscular dysplasia
suspect ____ in patients with a triad of HTN, hypokalemia, and metabolic alkalosis
hyperaldosteronism
a high ____ ratio suggest hyperaldosteronism
aldosterone:renin
____ is important cause of HTN in children. what is a classic finding on physical exam
coarctation of the aorta;
HTN in arms, decreased bp in legs
eye findings with severe HTN: 3
retinal hemorrhages, exudates, and papilledema
HTN is based on an average of ____ or greater readings taken at ____ or greater office visits after initial screening visit
2, 2
patients with increased ______ mass have a marked increased risk of CVD (Cardiovascular disease)
LV
low risk patients (no diabetes, CKD, or organ damage) and are greater than ____ years old should be started with drugs at _____ over 90 mm Hg. patients younger than _____ years old should be started with drugs at _____ over 90
60, 150;
60, 140
high risk patients include those with ____, ____ or organ damage. they should be started on drugs with a goal to get below ____ over 80
diabetes, CKD
130 (according to JCN 7)
what is a DASH diet?
dietary approaches to stop HTN;
e.g. fruits/veggies, low fat
what are the 2 most common/extensively used drug classes to treat HTN
thiazide diuretics, ACE inhibitors (or ARB)
____ are especially indicated in patients with CAD, post MI, or LV dysfunction
beta blockers
_____ are indicated in patients with prostatism
alpha blockers
_____ improve survival in patients with increased cardiovascular risk by preventing LV remodeling
ACE inhibitors
