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.