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45 Cards in this Set
- Front
- Back
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__% of HTN is idiopathic.
__% of HTN is renovascular. |
95% idiopathic, 4% renal, (1% OTHER)
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How many ppl in the US have HTN?
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50 million
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"Pre" hypertension =
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SBP 120-139
DBP 80-89 |
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Stage 1 HTN =
Needs f/u in... |
SBP 140-159
DBP 90-99 2 months |
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Stage 2 HTN =
Needs f/u in... |
SBP over 160
DBP over 100 1 month |
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Stage 3 HTN =
Needs f/u in... |
SBP over 180
DBP over 110 1 week |
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Stage 4 HTN =
Needs f/u in... |
SBP over 210
DBP over 120 next day! |
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What is "resistant HTN?"
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failing 3 drugs (HCTZ, atenolol, lisinopril) at their MAXIMAL doses!
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What is isolated systolic HTN of the elderly?
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abnormal systolic/nL diastolic
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What comorbities are important to ask about with HTN?
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1. DM, renal insufficiency and proteinuria
2. CAD, CHF 3. asthma 4. stroke, TIA |
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What further diagnostic tests might you want to get with HTN?
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1. lytes
2. cholesterol 3. EKG 4. urinary albumin/Cr ratio for diabetics to see is microalbuminuria 5. MRA or nuclear renal scan to see if renal artery stenosis |
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Lifestyle modifications?
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1. weight loss, exercise
2. lower EtOH 3. lower salt |
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4 main classes of antihypertensives:
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1. ACEi, ARB
2. beta blocker 3. Ca blocker 4. diuretic |
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Target BP if have DM or chronic kidney disease:
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130/80! (Otherwise 140/90)
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___ makes a good 2nd agent due to synergy.
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HCTZ
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ACEi
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block AII --> vasodilation
cough (10%), hyperkalemia, reversible renal failure (initial 35% rise Cr is OK) |
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beta blockers
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lower cardiac output, lower renin activity
bradycardia (target 55-70), heart failure, bronchospasm, masking hypoglycemia |
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Ca blockers
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smooth muscle relax --> vasodilation
edema, HA, dizzy |
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diuretics
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1st: lower blood volume and CO
later: lower resistance, nL CO hypokalemia, hyperuricemia |
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alpha blockers
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vasodilation
syncope, orthostatic hypotension |
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minoxidil
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vasodilation!!
fluid retention!!, reflex tachy |
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uncomplicated HTN
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HCTZ
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diabetes + HTN
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ACEi, ARB
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CAD + HTN
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beta blocker, ACEi
avoid short acting Ca blocker |
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isolated systolic HTN of elderly
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HCTZ, dihydropyridine (nifedipine)
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LVH + HTN
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HCTZ, ACEi
avoid hydralazine, minoxidil |
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heart failure + HTN
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ACEi, diuretic, beta blocker, spironolactone
avoid Ca blocker (amlodipine OK, verapamil not) |
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renal failure (Cr > 2.5)
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ACEi, ARB, furosemide
avoid HCTZ and spironolactone |
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h/o stroke + HTN
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HCTZ, ACEi
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asthma
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avoid beta blocker
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pregnancy + HTN
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methyldopa, beta blocker, vasodilators
AVOID ACEi, ARB! |
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African American with HTN
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diuretic, Ca blockers
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migraine, esophageal varices, HTN
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beta blocker (propranolol)
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calcium kidney stone, osteoporosis, HTN
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HCTZ
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benign prostatic hypertrophy, HTN
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alpha blocker (terazocin)
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HCTZ dosage and ranges
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25, 50
12.5 - 50 mg PO qd |
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atenolol (Tenormin) - selective beta 1 blocker dosage and ranges
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25, 50, 100
25 - 100 mg PO qd |
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lisinopril (Zestril, Prinivil) dosage and ranges
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2.5, 5, 10, 20, 40
2.5 - 40 mg PO qd |
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nifedipine (Procardia XL) - dihydropyridine CCB dosage and ranges
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30, 60, 90
30 - 90 mg PO qd |
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losartan (Cozaar) dosage and ranges
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25
25 - 100 mg PO qd |
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diltiazem (ER) - nondihydropyridine CCB dosage and ranges
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120, 180, 240
120 - 420 mg PO qd |
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terazocin (Hytrin) dosage and ranges
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1, 2, 5, 10
1 - 10 mg PO qd |
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labetalol (Normodyne) - alpha and beta blocker dosage and ranges
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100, 200
100 - 600 mg PO bid |
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furosemide (Lasix) dosage and ranges
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20, 40, 80
20 - 80 mg PO qd |
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minoxidil (Loniten) - vasodilator dosage and ranges
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2.5, 10
2.5 - 20 mg PO bid |
