UTA Family 3 Final Exam with 100% correct answers(verified for accuracy)

2017 ACC/AHA guidelines: normal BP <120 / <80 2017 ACC/AHA guidelines: elevated BP 120-129/ <80 Previous Play Next Rewind 10 seconds Move forward 10 seconds Unmute 0:03 / 0:15 Full screen Brainpower Read More 2017 ACC/AHA guidelines: stage 1 HTN 130-139 / 80-89 2017 ACC/AHA guidelines: stage 2 HTN ≥ 140/ ≥ 90 What is recommended for white coat hypertension? - lifestyle modification - annual ABPM or HBPM What is recommended for masked hypertension? - lifestyle modification - start HTN medication What is recommended for elevated BP? - lifestyle modification - annual ABPM What is secondary hypertension? - drug resistant/induced hypertension - exacerbation of previously controlled hypertension - accelerated/malignant hypertension - unprovoked or excessive hypokalemia What are common causes of secondary hypertension? - renal disease - aldosteronism - OSA - drug and alcohol induced What are non-pharmacological interventions for hypertension? - weight loss - DASH diet - sodium reduction - potassium supplementation - reduce alcohol consumption 2017 ACC/AHA guidelines: clinical CVD and BP ≥ 130 / ≥ 80 use BP lowering meds 2017 ACC/AHA guidelines: primary prevention in adults 10 yr ASCVD risk of ≥ 10% use BP lowering meds 2017 ACC/AHA guidelines: 10 yr risk < 10% and SBP ≥ 140/90 use BP lowering meds 2017 ACC/AHA guidelines: normal BP reassessment yearly 2017 ACC/AHA guidelines: elevated BP reassessment 3-6 months 2017 ACC/AHA guidelines: stage 1 HTN reassessment and 10 yr ASCVD < 10% 3-6 months 2017 ACC/AHA guidelines: stage 2 HTN reassessment one month until goal BP met, then 3-6 months 2017 ACC/AHA guidelines: stage 1 HTN reassessment and 10 yr ASCVD > 10% one month until BP goal met, then 3-6 months What hypertensive medications should not be prescribed simultaneously? - ACE - ARB - Renin Inhibitor 2017 ACC/AHA guidelines: first line agents - thiazide diuretics - CCBs - ACE - ARBs 2017 ACC/AHA guidelines: initiation of drug therapy in stage 2 HTN initiate drug therapy with 2 first line medications of different classes as separate agents or combo drug 2017 ACC/AHA guidelines: initiation of drug therapy in stage 1 HTN initiate therapy with a single drug 2017 ACC/AHA guidelines: HTN reassessment for new or adjusted drug regimen follow up at monthly intervals until control is sustained 2017 ACC/AHA guidelines: black adults with HTN, no HF or CKD initiate therapy with thiazide diuretic or CCB 2017 ACC/AHA guidelines: pregnant or planning pregnancy safe drug choice - methyldopa - nifedipine - labetalol 2017 ACC/AHA guidelines: drugs contraindicated in pregnant women - ACE - ARBs - direct renin inhibitors 2017 ACC/AHA vs JNC 8 older community dwelling adults ≥ 65 yo - JNC 8 treat BP if > 150/90 - 2017 treat if SBP ≥ 130 2017 ACC/AHA guidelines: hypertensive crisis > 180/120 admit to ICU if target organ damage 2017 ACC/AHA guidelines: secondary stroke prevention BP threshold ≥ 140/90 2017 ACC/AHA guidelines: no CVD and ASCVD risk < 10% BP threshold ≥ 140/90 TOD brain - CVA - encephalopathy - dementia - multi infarct - early cognitive decline TOD eyes - flame hemorrhage - papilloedema - hard exudates - cotton wool spots TOD heart - LVH - CAD - MI - rhythm disorders - aortic and PAD - AAA TOD kidneys - CKD - GFR < 60 TOD erectile dysfunction - CVD risk factor - early diagnostic indicator - need full sexual history Diagnosis of HTN is made on the 3rd elevated BP 2017 ACC/AHA guidelines: hypertensive URGENCY - elevated BP without current organ damage - happens when patients stop taking their meds - doesn't require a rapid decrease - check proteinuria and BMP - one week follow up During hypertensive URGENCY lower BP with these drugs - furosemide 20 mg or higher - clonidine 0.2 mg Clinical evidence for Accelerated HTN - severe arteriosclerosis - grade 3 or 4 hypertensive retinopathy - renal insufficiency for which there is no apparent cause - prognosis if untreated poor List meds that can elevate BP - oral contraceptives - cyclosporine - TCAs - sympathomimetic decongestants - appetite suppressants - corticosteroids - NSAIDs -erythropoietin - anabolic steroids - MAOI - Norepinephrine reuptake inhibitors