Flashcards in Resistant HTN Deck (84)
What is resistant HTN?
When you have tried 3 different BP meds at max dose and are still hypertensive
120-139 OR 80-89
Stage 1 HTN?
140-159 OR 90-99
Stage 2 HTN?
Over 160 OR over 100
What is the BP goal in average population?
What conditions turn the goal BP into 130/80?
Kidney disease, heart disease, or diabetes
What is the most common form of HTN?
If your patient doesn't have essential HTN, what's the next most likely cause?
If your patient has HTN, what do you do first?
Is weight reduction good for lowering BP?
Not so much...although it's good for overall health, weight reduction doesn't have a direct effect on lowering BP
How does exercise help lower BP?
It reduces vascular tone
If life style modifications didn't work and your patient has Stage 1 HTN, what is the 1st drug you should give?
Either a diuretic (thiazide-type) or beta blocker
If your patient has chronic kidney disease (stage 3 or lower) or diabetes, what should your first-line drug be for Stage 1 HTN?
ACEi or ARB
If your patient presents with Stage 2 HTN, what will you do?
Give 2 drugs...thiazide diuretic and and another drug (usually beta-blocker)
Which drug class shows decreased mortality in patients with CHF or CAD?
So if your patient has CHF and CAD and is HTN, what do you give them?
Probably go with a diuretic and beta blocker, if they have CHF too, possibly consider ACEi as well
If the first drug you prescribed was a beta blocker for your HTN patient, and they still aren't at their goal, what should be the 2nd drug you add?
Why is it so important to have diuretics on board to treat HTN?
Because a diuretic will decrease Na/Volume which will activate the RAA system, which then will let your ACEi/ARB come in and work more effectively to squash it
-Basically, diuretics make the other BP meds more effective
When would you prescribe a CCB for HTN and why?
In situations where the patient is allergic to other drugs...CCV don't have a benefit in mortality and are really only to be used as supplements once the other drugs have been tried
What stages of kidney disease can ACEi and ARB be used in?
Anything stage 3 or lower
Why can't ACEi or ARB be used in Stage 4 or Stage 5 kidney disease?
Because they block RAA and can block perfusion to the kidney resulting in a decrease in GFR in a kidney that already has a low GFR leading to acute kidney failure
What condition do you not give ACEi or ARB to a patient due to the risk of triggering acute kidney failure?
Bilateral renal artery stenosis
GFR in Stage 3 kidney disease?
GFR in Stage 4 kidney disease?
GFR in Stage 5 kidney disease?
Under 15 --> They need dialysis
What drug class is given more often to patients with HTN and Type I diabetes?
What drug class if given more often to patients with HTN and Type II diabetes?
If your patient is taking an ACEi and gets a nasty cough, what do you do?
Switch them to an ARB