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45 Cards in this Set

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  • Back
__% of HTN is idiopathic.

__% of HTN is renovascular.
95% idiopathic, 4% renal, (1% OTHER)
How many ppl in the US have HTN?
50 million
"Pre" hypertension =
SBP 120-139
DBP 80-89
Stage 1 HTN =

Needs f/u in...
SBP 140-159
DBP 90-99

2 months
Stage 2 HTN =

Needs f/u in...
SBP over 160
DBP over 100

1 month
Stage 3 HTN =

Needs f/u in...
SBP over 180
DBP over 110

1 week
Stage 4 HTN =

Needs f/u in...
SBP over 210
DBP over 120

next day!
What is "resistant HTN?"
failing 3 drugs (HCTZ, atenolol, lisinopril) at their MAXIMAL doses!
What is isolated systolic HTN of the elderly?
abnormal systolic/nL diastolic
What comorbities are important to ask about with HTN?
1. DM, renal insufficiency and proteinuria
2. CAD, CHF
3. asthma
4. stroke, TIA
What further diagnostic tests might you want to get with HTN?
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
Lifestyle modifications?
1. weight loss, exercise
2. lower EtOH
3. lower salt
4 main classes of antihypertensives:
1. ACEi, ARB
2. beta blocker
3. Ca blocker
4. diuretic
Target BP if have DM or chronic kidney disease:
130/80! (Otherwise 140/90)
___ makes a good 2nd agent due to synergy.
HCTZ
ACEi
block AII --> vasodilation

cough (10%), hyperkalemia, reversible renal failure (initial 35% rise Cr is OK)
beta blockers
lower cardiac output, lower renin activity

bradycardia (target 55-70), heart failure, bronchospasm, masking hypoglycemia
Ca blockers
smooth muscle relax --> vasodilation

edema, HA, dizzy
diuretics
1st: lower blood volume and CO
later: lower resistance, nL CO

hypokalemia, hyperuricemia
alpha blockers
vasodilation

syncope, orthostatic hypotension
minoxidil
vasodilation!!

fluid retention!!, reflex tachy
uncomplicated HTN
HCTZ
diabetes + HTN
ACEi, ARB
CAD + HTN
beta blocker, ACEi

avoid short acting Ca blocker
isolated systolic HTN of elderly
HCTZ, dihydropyridine (nifedipine)
LVH + HTN
HCTZ, ACEi

avoid hydralazine, minoxidil
heart failure + HTN
ACEi, diuretic, beta blocker, spironolactone

avoid Ca blocker (amlodipine OK, verapamil not)
renal failure (Cr > 2.5)
ACEi, ARB, furosemide

avoid HCTZ and spironolactone
h/o stroke + HTN
HCTZ, ACEi
asthma
avoid beta blocker
pregnancy + HTN
methyldopa, beta blocker, vasodilators

AVOID ACEi, ARB!
African American with HTN
diuretic, Ca blockers
migraine, esophageal varices, HTN
beta blocker (propranolol)
calcium kidney stone, osteoporosis, HTN
HCTZ
benign prostatic hypertrophy, HTN
alpha blocker (terazocin)
HCTZ dosage and ranges
25, 50
12.5 - 50 mg PO qd
atenolol (Tenormin) - selective beta 1 blocker dosage and ranges
25, 50, 100
25 - 100 mg PO qd
lisinopril (Zestril, Prinivil) dosage and ranges
2.5, 5, 10, 20, 40
2.5 - 40 mg PO qd
nifedipine (Procardia XL) - dihydropyridine CCB dosage and ranges
30, 60, 90
30 - 90 mg PO qd
losartan (Cozaar) dosage and ranges
25
25 - 100 mg PO qd
diltiazem (ER) - nondihydropyridine CCB dosage and ranges
120, 180, 240
120 - 420 mg PO qd
terazocin (Hytrin) dosage and ranges
1, 2, 5, 10
1 - 10 mg PO qd
labetalol (Normodyne) - alpha and beta blocker dosage and ranges
100, 200
100 - 600 mg PO bid
furosemide (Lasix) dosage and ranges
20, 40, 80
20 - 80 mg PO qd
minoxidil (Loniten) - vasodilator dosage and ranges
2.5, 10
2.5 - 20 mg PO bid