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24 Cards in this Set

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What is Kaplan's conceptual definition of hypertension?
That level of BP at which the benefits (minus the risks and costs) of action exceed the risks and costs (minus the benefits) of inaction.
What increase in risk of stroke and CHD is seen with a 5.0 mmHg risk in diastolic BP?
34% increase in stroke risk
21% increase in CHD risk

Reference: MacMahon et al's 1990 metaanalysis of prospective observational studies on HTN.
Is HTN tolerated better in women or men?
Women have shown to tolerate HTN better than do men and have lower coronary mortality rates with any level of HTN.
How did the mortality rate of CHD and stroke compare in blacks with a DBP > 90 vs. whites in the MRFIT study?
mortality rate of CHD was lower in black men (RR 0.84), however, the mortality rate of cerebrovascular disease was higher (RR 2.0)
How does the prevalence of HTN and cardiovascular disease compare in Hispanics compared to whites?
HTN rates are similar to or lower than that for whites

cardiovascular disease rates are lower than that for whites

Hispanics, however, have a higher prevalence of obesity and DM than do whites
Are individuals greater than age 65 at greater risk from HTN than those less than 65 years of age?
Yes, they are at greater risk for cardiovascular disease
What measure of blood pressure (diastolic, systolic, or pulse pressure) is the strongest predictor of CHD risk in the following age groups:
< 50 years old
50 to 59 years old
> 60 years old
<50 diastolic BP

50 to 59 all 3 indices are comparible

> 60 DBP is negatively predictive
Pulse pressure superior to
SBP
What is the prevalence of isolated systolic HTN in the population overall? in patients older than 50?
65% in population overall

80% in those over age 50
What levels of SBP and DBP are associated with poorer prognosis in those over age 85?
SBP < 125, DBP < 65

Explanation: As older patients develop CV disease and cardiac pump function deteriorates, systolic levels often fall and a U-shaped curve of cardiovascular mortality becomes obvious.
What percentage of patients are correctly classified as hypertensive based on their SBP?
96%
According to JNC 6 what is the definition of optimal BP?
SBP <120 and DBP <80
According to JNC 6 what is the definition of "Normal" blood pressure?
SBP <130 and DBP <85
According to JNC 6 what is the definition of "High Normal" blood pressure?
SBP 130-139 or DBP 85-89
According to JNC 6 what is the definition of "Stage 1 Hypertension"?
SBP 140-159 or DBP 90-99
According to JNC 6 what is the definition of "Stage 2 Hypertension"?
SBP 160-179 or DBP 100-109
According to JNC 6 what is the definition of "Stage 3 Hypertension"?
SBP >180 or DBP >110
What is the overall prevalence of HTN in the United States?
20%
How does the prevalence of HTN in blacks compare to that in whites?
It is twice as common in blacks as in whites
Is death from HTN more common in blacks or whites?
it is more common in blacks
How does the prevalence of HTN compare in Hispanics vs. whites?
although the prevalence of HTN is similar in these two populations it is less well controlled
How does the prevalence of HTN compare in Asian Americans and Pacific Islanders compared to whites?
prevalence is similar to or lower than that in whites
How does the prevalence of HTN in Native Americans compare to whites?
HTN as prevalent in whites as in Native Americans

Rates of cardiovascular disease, however, are even higher in Native Americans than in whites
True/False: More cardiovascular mortality will occur in those with a diastolic BP of 80 to 84 than among those with a diastolic BP of 95 mmHg or greater.
true

For the individual patient, the higher the level of BP the greater the risk of morbidity and mortality.

However, for the population at large, the greatest burden from HTN occurs among people with only minimally elevated pressures, because there are so many of them.
What percent of HTN seen in the Framinham study was attributable to obesity?
70% in men
61% in women