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26 Cards in this Set
- Front
- Back
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mcc of secondary HTN
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1) renal artery stenosis
2) OCP (in women) |
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what are common early eye complications of HTN?
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arteriovenous nicking - discontinuity in the retinal vein secondary to thickened arterial walls
cotton wool spots - infarction of the nerve fiber layer in the retina |
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what is the definition normal BP?
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systolic: <120
diastolic: <80 txt: (none) |
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what is the definition of prehypertension and how do you treat?
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systolic: 120-139
diastolic: 80-89 txt: lifestyle modification |
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what is the definition of Stage 1 HTN and how do you treat?
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systolic: 140-159
diastolic: 90-99 txt: lifestyle modification + (1) drug |
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what is the definition of Stage 2 HTN and how do you treat?
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systolic: >160
diastolic: >100 txt: lifestyle modification + (2) drug |
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how is HTN diagnosed?
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two readings
(4+ weeks between readings) unless: - end-organ damage - severe HTN |
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how do you measure BP? (4)
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- arm at heart level
- 5 minutes of pt rest - no caffine or cigarettes within last 30 min - BP cuff encircles at least 80% of arm |
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what is the first line medication for HTN and its SE's?
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thiazide diuretics
SE: - hypokalemia (check regularly, spironolactone to couteract) - hyponatremia - hypercalcemia - incr LDL/TG - incr glucose |
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what is the MOA for beta-blockers in terms of HTN managment?
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- decr HR + CO
- decr renin release - decr arteriolar resistance - (secondary benefits in BPH) - (secondary benefits in benign essential tremor) |
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what is the drug of choice for HTN in diabetic pts and why?
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ACE inhibitors, they are nephro-protective in diabetics
- inhibit renin-angiotensin-aldosterone system - inhibit bradykinin degredation (ARBs have same benefits) |
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what is BP goal for HTN treatment?
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<140/90
(<135/85 in diabetics) |
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which drugs reduce morbidity and mortality in HTN managment?
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1) thiazide diuretics
2) beta-blockers (ACE-i's for diabetics?) |
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what drugs can cause hyperlipidemia? (4)
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1) thiazide diuretics
- incr LDL/total/TG 2) b-blockers - incr TG - decr HDL 3) estrogens - incr TG 4) corticosteroids - incr serum lipids |
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what are the risks of high/low total-to-HDL ratios?
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5.0 is average risk
10 is double risk 20 is triple risk (< 4.5 is desirable) |
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what are considered high levels for total cholesterol, LDL and TGs?
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total: >240
LDL: >160 TGs: >250 |
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pancreatitis can occur secondary to elevation in this lipid.
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TGs
(hypertriglyceridemia) |
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how is hyperlipidemia diagnosed?
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non-fasting total and HDL, if either abnormal then order a full fasting lipid profile (includes TG and LDL levels)
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what is the treatment goal for hyperlipidemia?
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reduce CHD risk and LDL levels
- <130 for no CHD risk - <100 for any CHD risk or DM |
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when do you treat hypertriglyceridemia and with what drug?
what are the common SE's? |
treat TGs >500 mg/dL with niacin first line
(gemfibrozil second-line) SE of niacin: - cutaneus flushing from prostaglandins - reversed with aspirin |
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when do you initiate therapy for hyperlipidemia for someone with CHD or risk equivalents?
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>130 mg/DL
(goal <100) |
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what are CHD risk equivalents? (4)
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1) AAA
2) PVD 3) CAD 4) DM |
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when do you initiate therapy for hyperlipidemia for someone with >2 risk factors for CHD?
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>130 mg/DL
(goal <130) |
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when do you initiate therapy for hyperlipidemia for someone with 2 risk factors for CHD?
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>160 mg/DL
(goal <130) |
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when do you initiate therapy for hyperlipidemia for someone with 0-1 risk factors for CHD?
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>190 mg/DL
(goal <160) |
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what are the risk factors for CHD? (7)
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1) smoking
2) HTN 3) DM 4) low HDL 5) age - male >45 - female >55 6) male 7) famhx of premature CAD (MI) |
