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25 Cards in this Set
- Front
- Back
Definition in Dx of High Blood Pressure
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Systolic > or equal to 140 mm Hg
Diastolic > or equal to 90 mm Hg |
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What is a normal BP reading?
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130/80 mm Hg
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What is the pre-hypertension range?
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130-139 Systolic
80-89 Diastolic |
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Stage 1 (Mild)
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140-159 Systolic
90-99 Diastolic |
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Stage 2 (Moderate)
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160-179 Systolic
100-109 Diastolic |
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Stage 3 (Severe)
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180-209 Systolic
110-119 Diastolic |
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Stage 4 (Very Severe)
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210 Systolic
120 Diastolic |
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What is a hypertensive emergency?
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Sustained diastolic BP >130 mm Hg
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Essential (Primary) Hypertension
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No specific cause of hypertension can be found
Genetic inheritance, psychological stress, and environmental and dietary factors associated. |
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Secondary Hypertension
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~10% of patients
Specific cause can be identified Chronic renal disease Adrenal Gland Tumors Obstructive Sleep Apnea |
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Early Stage Presentation
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Asymptomatic except for elevated BP
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End Organ Damage Presentation: CVs
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Stroke, infarcts in cerebral vessels, intracerebral hemorrhage, TIAs
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End Organ Damage Presentation: Eye
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Accelerated arteriosclerosis, retinal infarcts, papilledema (sweling of the optic disc), and retinopathy
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End Organ Damage Presentation: Heart
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Left ventricular hypertrophy and heart failure, coronary artery diseases, myocardial infarction
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End Organ Damage Presentation: Kidney
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Arteriosclerosis and renal failure
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Treatment of Hypertension: Non-Pharm
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Dietary sodium restriction (<2.3 gm/day)
High-fiber, low-fat diet Weight control Exercise Life style change (tobacco cessation, decrease in alcohol and caffeine consumption) |
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Tx of Hypertension: Pharm
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Reduction of the incidence of progressive cardiovascular and renal complications can occur with pharm interventions.
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What is the goal of anti-hypertensive therapy?
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Produce a sustained lowering of BP by reducing total peripheral resistance (TPR). Almost all hyper patients have normal cardiac output and elevated TPR.
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Hyper therapy and Effectiveness
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Medication must be taken regularly
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Category: Diuretics
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Thiazide diu.: Hydrochlorothiazide (Carozide)
Loop diu.: Furosemid (Lasix) Potassium-sparing diu.: Spironolactone (Aldactone) |
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Category: Sympatholytic
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Centrally acting agents: Clonidine (Catapres)
Beta-adrenoceptor blockers ("-olols"): Propranolol (Inderal), Metoprolol (Lopressor) and Atenolol (Tenormin) Alpha-adrenoceptor blockers: Prazosin (Minipress), Terazosin (Hytrin) and Doxazosin (Cardura) Mixed blockers: Labetalol (Normodyne, Trandate, Vescal) and Carvedilol (Coreg) |
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Direct Vasodilators
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Arterial vaso: Minoxidil (Loniten) and Hydralazine (Apresoline)
Calcium Channel Blockers: Amlodipine (Vorvasc), Verapamil (Isoptin, Calan) and Nifedipine (Procardia, Adalat) |
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Inhibitors of Angiotensin System
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ACE inhibitors: Lisinopril (Prinivil, Zestril) and Ramipril (Altace)
Angio Receptor blockers: Losartan (Cozaar) and Valsartan (Diovan) |
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Centrally Acting Agent: Clonidine (Catapres)
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Site and MOA: CNS-alpha adrenoceptor agonist. Lowers sympathetic outflow and increases vagal tone, decreasing cardiac output and peripheral resistance
Use of drug: second or third line drug choice for lowering BP and in hypertensive crisis SE: sedation or drowsiness, rebound hypertension of drug withdrawal, dry mouth and constipation, sexual dysfunction, and compensatory response including water and sodium retention |
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Adrenoceptor Blockers: Beta-adrenoceptor
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Cardioselective: Atenolol (Tenormin)
Non-cardio: Propranolol (Inderal) MOA: Decrease CO by blocking beta 1 adrenoceptor; block beta 1 adrenoceptor-mediated renin release; may have CNS sympatho-inhibitory actions |