STEP 2 CARDS: HTN

Question 1

A pt is dx’d w/ new onset primary hypertension. What shouls the physician do next for evaluating this patient?

Answer 1

screen for complications/comorbid conditions. Order: HbA1C, lipid panel, chem panel (serum Cr, BUN, K), ECG Urinarlysis

Question 2

Stage 1 Hypertension

Answer 2

SBP> or= 130-139, or DBP > or =80-89

Question 3

What are our drugs of choice for HTN?

Answer 3

TAC: thiazide diuretics, ACE/ARB, CCBs

Question 4

Thiazides are our first line choice except when…

Answer 4

PRIOR MI, CAD, HF, AFIB, hyperthyroid: BB
CKD/Proteinuria/DM: ACEs or ARBs (renoprotective in DM)
BPH: alpha blockers
Osteoporosis: Thiazides
Preggos: Hydrazaline, Labetolol, Methyldopa, Nifedipine
Asthma: ARBs (NOT aces), CCBs, thiazides, cardioselective BB

Question 5

What are the activity recommendations?

Answer 5

150 min/wk mod intensity

Question 6

ARB lab impacts

Answer 6

ARBs can cause elevations in creatinine and potassium. The rise in creatinine and hyperkalemia are problems for patients with concurrent chronic kidney disease. ARBs do not cause hyperkalemia in patients without chronic kidney disease.

Question 7

ACE side effects

Answer 7

ACE inhibitors may also induce angioedema or a chronic dry cough.

Question 8

the primary side effect of cardioselective β-blockers such as metoprolol.

Answer 8

bradycardia

Question 9

Side effects of thiazides

Answer 9

hypo-k
hypo-mg

Question 10

Treatment of hypertensive emergency

Answer 10

Treatment involves using an infusion of a titratable antihypertensive agent to achieve a rapid reduction in the MAP by 25%, maintained for one hour. Commonly used medications include esmolol, nicardipine, and less often, nitroprusside.

Question 11

What lifestyle interventions have the highest reduction in BP?

Answer 11

Weight loss and diet; especially weight loss in those who are obese

Question 12

Isolated elevated systolic hypertension is associated with (increased/decreased) systolic compliance associated mostly with _______________.

Answer 12

Isolated elevated systolic hypertension is associated with decreased systolic compliance associated mostly with aging.

Older patient has a wide pulse pressure with elevated systolic blood pressure and normal diastolic pressure. Isolated systolic hypertension is caused by decreased arterial elasticity and compliance associated with aging. This condition most commonly occurs in adults aged over 60 years and typically manifests with wide pulse pressure. Patients with isolated systolic hypertension have a high risk of renal dysfunction and cardiovascular events, e.g., myocardial infarction, stroke.

Question 13

What is the first line tx fro htn in african americans?

Answer 13

African American patients with isolated hypertension. Thiazide diuretics are considered especially effective antihypertensive agents because impaired salt excretion and subsequent intravascular volume expansion are thought to be the primary drivers of hypertension in this patient group.

Potential adverse effects of the first-line drug for this condition include hypokalemia, hyperglycemia, and hypercalcemia.

Question 14

hypertensive vasculopathy increases your risk of what major adverse event?

Answer 14

intracerebral hemmorhage