NURP 533 Test 1 Week 1 -3 terms Ques ons and
answers | Updated RATED A+ | 2026
Hypertension classifica on is based on the
average of two or more properly measured, seated BP recordings on each of two or more office
visits. This point is emphasized in the 2017 guidelines.
2017 ACC/AHA criteria for hypertension.2
Normal blood pressure: SBP <120 mm Hg AND DBP < 80 mm Hg
Elevated blood pressure: SBP 120 - 129 mm Hg AND DBP <80 mm Hg
Stage 1 HTN: SBP 130 - 139 mm Hg OR DBP 80 - 89 mm Hg
Stage 2 HTN: SBP > 140 mm Hg OR DBP >90 mm Hg
Non pharm tx for HTN
Lifestyle modifica on, including diet (both low sodium and DASH diet—high in fruits,
vegetables, and low-fat dairy products and reduced saturated and total fat), exercise, weight
loss, and modera on of alcohol consump on (men: limit to less than or equal to two drinks per
day; women and lighter-weight persons: limit to less than or equal to one drink per day)
guidelines for elevated BP or stage 1 + ascvd risk <10%
tx with non pharmacologic therapy (lifestyle modifica ons) is recommended with a repeat BP
evalua on in 3 to 6 months.
guidelines for stage 1 htn + ascvd risk >10%
tx is a combina on of lifestyle modifica ons and 1-drug treatment is recommended with follow-
up blood pressure evalua on in a month.
guidelines for stage 2 htn
•in addi on to lifestyle modifica ons, the recommended treatment is to use 2 drugs from
different classes with a recheck of blood pressure in a month.
guidelines for adults with high average BP (>180/110)
eval followed by prompt an hypertensive drug tx
What test(s) should you order in ini al HTN workup?
,comprehensive H/P, blood glucose, CBC, lipid profile, BUN, serum crea nine with es mated
GFR, serum sodium, potassium, and calcium, a TSH, UA, and an ECG. Op onal tests include an
echocardiogram, uric acid, and urinary albumin to crea nine ra o.
The American Diabetes Associa on (2020) recommends screening for diabetes in
adults of any age who are overweight or obese (BMI greater than 25 kg/m2) and have another
risk factor (such as hypertension).4 For those without addi onal risk factors, the BMI greater
than 25 kg/m2 should only prompt screening for diabetes at age 45 years old or older
According to the 2017 guidelines, for adults with confirmed hypertension and known CVD or 10-
year ASCD event risk greater than or equal to 10%, a target of
<130/80 mm Hg is recommended. For those without addi onal markers of increased CVD risk, a
BP target < 130/80 mm Hg may be reasonable.
the recommended ini al an hypertensive agents should include
thiazide-type diure c, calcium channel blocker (CCB), angiotensin-conver ng enzyme (ACE)
inhibitor, or an angiotensin II receptor blocker (ARB). ACE inhibitors and ARBs should not be
used in combina on. Remember, if there is a chance that the pa ent could become pregnant,
ACE inhibitors and ARBs are pregnancy category X.
tx for HTN + CHF
Thiazides, beta blockers, ACE inhibitors, ARBs, aldosterone antagonist
Tx for HTN + Post MI
Beta blockers, ACE inhibitors, aldosterone antagonist
tx for HTN + high CVD risk
Thiazides, beta blockers, ACE inhibitor, CCB
tx for HTN +DM
Thiazides, beta blockers, ACE inhibitor, ARB, CCB
tx for HTN + CKD
ACE inhibitor, ARB
tx for HTN + Recurrent stroke preven on
Thiazides, ACE inhibitor
tx for HTN +BPH
,Alpha blocker (generally not recommended for
HTN, but in pa ents with this condi on, alpha blockers may be useful)
RF associated with dx of secondary HTN
Drug-resistant/induced hypertension, Abrupt onset of hypertension, Onset of hypertension at
age younger than 30 years old, Exacerba on of previously controlled hypertension,
Accelerated/malignant hypertension, Onset of diastolic hypertension in older adults (age older
than 65 years old), Unprovoked or excessive hypokalemia
how common is secondary HTN
secondary hypertension accounts for 5% to 10% of hypertension in adults; secondary
hypertension is much more common in the (approximate) 10% of children who have
hypertension.
10 causes of Secondary HTN
Apnea (OSA)
Aldosteronism (Primary hyperaldosteronism)
Bruits (Renovascular disease such as renal artery stenosis or fibromuscular dysplasia)
Bad parenchymal disease (Chronic kidney disease)
Catecholamines (Pheochromocytoma, other catecholamine release situa ons,
decongestants, herbal prepara ons)
Coarcta on of the aorta
Cushing's syndrome and other excess glucocor coid states
Drug induced or related
Diet (excess of sodium, alcohol, black licorice)
Erythropoie n excess (exogenous or secondary to COPD/polycythemia)
Endocrine disorders (not already listed): hypothyroidism, hyperthyroidism,
hyperparathyroidism, pregnancy-induced hypertension, pheochromocytoma, acromegaly
2017 ACC/AHA Guidelines for HTN TX
For pa ents with elevated blood pressure or stage 1 htn + es mated 10-year ASCVD risk of less
than 10%, nonpharmacologic therapy (lifestyle modifica ons) is recommended with a repeat BP
evalua on in 3 to 6 months.
, For pa ents w/ stage 1 HTN + an es mated 10-year ASCVD risk greater than or equal to 10%, a
combina on of lifestyle modifica ons and 1-drug treatment is recommended with follow-up
blood pressure evalua on in a month.
For pa ents w/ stage 2 htn, + to lifestyle modifica ons, the recommended treatment is to use 2
drugs from different classes with a recheck of blood pressure in a month.
For adults w/ very high average BP (eg, SBP greater than 180 mm Hg or DBP greater than 110
mm Hg), the recommenda on is evalua on followed by prompt an hypertensive drug
treatment.
Adults with well controlled hypertension can be followed annually.
lifestyle modifica ons for HTN tx
weight loss, DASH diet, reduce Na in diet, supplemental K (unless CKD), exercise, reduce alcohol
consump on
effects of lifestyle modifica ons for HTN
DASH diet - 8-14 mm Hg
Weight reduc on: 5 to 20 mm Hg per 10 kg weight loss
Dietary sodium restric on: 2 to 8 mm Hg
Physical ac vity: 4 to 9 mm Hg
Modera on in alcohol consump on: 2 to 4 mm Hg
tx for stage 2 HTN
According to the 2017 guidelines, stage 2 hypertension should be treated with a combina on of
lifestyle modifica on and ini al therapy with 2 drugs of different classes,).
The 1st line= thiazide diure cs (chlorthalidone is preferred), calcium channel blockers (CCBs),
and angiotensin-conver ng enzyme (ACE) inhibitors or angiotensin II receptor blocker (ARBs).
ACE inhibitors and ARBs should not be used together. Note that beta-blockers are not
recommended as first-line therapy as there is some evidence that beta-blockers may increase
stroke
TZD ADE (htn)
Hypokalemia, hypomagnesemia, hyponatremia, hypercalcemia, worsens or precipitates gout,
lipid abnormali es (elevated cholesterol and triglycerides), pancrea s, rash, photosensi vity,
erec le dysfunc on
answers | Updated RATED A+ | 2026
Hypertension classifica on is based on the
average of two or more properly measured, seated BP recordings on each of two or more office
visits. This point is emphasized in the 2017 guidelines.
2017 ACC/AHA criteria for hypertension.2
Normal blood pressure: SBP <120 mm Hg AND DBP < 80 mm Hg
Elevated blood pressure: SBP 120 - 129 mm Hg AND DBP <80 mm Hg
Stage 1 HTN: SBP 130 - 139 mm Hg OR DBP 80 - 89 mm Hg
Stage 2 HTN: SBP > 140 mm Hg OR DBP >90 mm Hg
Non pharm tx for HTN
Lifestyle modifica on, including diet (both low sodium and DASH diet—high in fruits,
vegetables, and low-fat dairy products and reduced saturated and total fat), exercise, weight
loss, and modera on of alcohol consump on (men: limit to less than or equal to two drinks per
day; women and lighter-weight persons: limit to less than or equal to one drink per day)
guidelines for elevated BP or stage 1 + ascvd risk <10%
tx with non pharmacologic therapy (lifestyle modifica ons) is recommended with a repeat BP
evalua on in 3 to 6 months.
guidelines for stage 1 htn + ascvd risk >10%
tx is a combina on of lifestyle modifica ons and 1-drug treatment is recommended with follow-
up blood pressure evalua on in a month.
guidelines for stage 2 htn
•in addi on to lifestyle modifica ons, the recommended treatment is to use 2 drugs from
different classes with a recheck of blood pressure in a month.
guidelines for adults with high average BP (>180/110)
eval followed by prompt an hypertensive drug tx
What test(s) should you order in ini al HTN workup?
,comprehensive H/P, blood glucose, CBC, lipid profile, BUN, serum crea nine with es mated
GFR, serum sodium, potassium, and calcium, a TSH, UA, and an ECG. Op onal tests include an
echocardiogram, uric acid, and urinary albumin to crea nine ra o.
The American Diabetes Associa on (2020) recommends screening for diabetes in
adults of any age who are overweight or obese (BMI greater than 25 kg/m2) and have another
risk factor (such as hypertension).4 For those without addi onal risk factors, the BMI greater
than 25 kg/m2 should only prompt screening for diabetes at age 45 years old or older
According to the 2017 guidelines, for adults with confirmed hypertension and known CVD or 10-
year ASCD event risk greater than or equal to 10%, a target of
<130/80 mm Hg is recommended. For those without addi onal markers of increased CVD risk, a
BP target < 130/80 mm Hg may be reasonable.
the recommended ini al an hypertensive agents should include
thiazide-type diure c, calcium channel blocker (CCB), angiotensin-conver ng enzyme (ACE)
inhibitor, or an angiotensin II receptor blocker (ARB). ACE inhibitors and ARBs should not be
used in combina on. Remember, if there is a chance that the pa ent could become pregnant,
ACE inhibitors and ARBs are pregnancy category X.
tx for HTN + CHF
Thiazides, beta blockers, ACE inhibitors, ARBs, aldosterone antagonist
Tx for HTN + Post MI
Beta blockers, ACE inhibitors, aldosterone antagonist
tx for HTN + high CVD risk
Thiazides, beta blockers, ACE inhibitor, CCB
tx for HTN +DM
Thiazides, beta blockers, ACE inhibitor, ARB, CCB
tx for HTN + CKD
ACE inhibitor, ARB
tx for HTN + Recurrent stroke preven on
Thiazides, ACE inhibitor
tx for HTN +BPH
,Alpha blocker (generally not recommended for
HTN, but in pa ents with this condi on, alpha blockers may be useful)
RF associated with dx of secondary HTN
Drug-resistant/induced hypertension, Abrupt onset of hypertension, Onset of hypertension at
age younger than 30 years old, Exacerba on of previously controlled hypertension,
Accelerated/malignant hypertension, Onset of diastolic hypertension in older adults (age older
than 65 years old), Unprovoked or excessive hypokalemia
how common is secondary HTN
secondary hypertension accounts for 5% to 10% of hypertension in adults; secondary
hypertension is much more common in the (approximate) 10% of children who have
hypertension.
10 causes of Secondary HTN
Apnea (OSA)
Aldosteronism (Primary hyperaldosteronism)
Bruits (Renovascular disease such as renal artery stenosis or fibromuscular dysplasia)
Bad parenchymal disease (Chronic kidney disease)
Catecholamines (Pheochromocytoma, other catecholamine release situa ons,
decongestants, herbal prepara ons)
Coarcta on of the aorta
Cushing's syndrome and other excess glucocor coid states
Drug induced or related
Diet (excess of sodium, alcohol, black licorice)
Erythropoie n excess (exogenous or secondary to COPD/polycythemia)
Endocrine disorders (not already listed): hypothyroidism, hyperthyroidism,
hyperparathyroidism, pregnancy-induced hypertension, pheochromocytoma, acromegaly
2017 ACC/AHA Guidelines for HTN TX
For pa ents with elevated blood pressure or stage 1 htn + es mated 10-year ASCVD risk of less
than 10%, nonpharmacologic therapy (lifestyle modifica ons) is recommended with a repeat BP
evalua on in 3 to 6 months.
, For pa ents w/ stage 1 HTN + an es mated 10-year ASCVD risk greater than or equal to 10%, a
combina on of lifestyle modifica ons and 1-drug treatment is recommended with follow-up
blood pressure evalua on in a month.
For pa ents w/ stage 2 htn, + to lifestyle modifica ons, the recommended treatment is to use 2
drugs from different classes with a recheck of blood pressure in a month.
For adults w/ very high average BP (eg, SBP greater than 180 mm Hg or DBP greater than 110
mm Hg), the recommenda on is evalua on followed by prompt an hypertensive drug
treatment.
Adults with well controlled hypertension can be followed annually.
lifestyle modifica ons for HTN tx
weight loss, DASH diet, reduce Na in diet, supplemental K (unless CKD), exercise, reduce alcohol
consump on
effects of lifestyle modifica ons for HTN
DASH diet - 8-14 mm Hg
Weight reduc on: 5 to 20 mm Hg per 10 kg weight loss
Dietary sodium restric on: 2 to 8 mm Hg
Physical ac vity: 4 to 9 mm Hg
Modera on in alcohol consump on: 2 to 4 mm Hg
tx for stage 2 HTN
According to the 2017 guidelines, stage 2 hypertension should be treated with a combina on of
lifestyle modifica on and ini al therapy with 2 drugs of different classes,).
The 1st line= thiazide diure cs (chlorthalidone is preferred), calcium channel blockers (CCBs),
and angiotensin-conver ng enzyme (ACE) inhibitors or angiotensin II receptor blocker (ARBs).
ACE inhibitors and ARBs should not be used together. Note that beta-blockers are not
recommended as first-line therapy as there is some evidence that beta-blockers may increase
stroke
TZD ADE (htn)
Hypokalemia, hypomagnesemia, hyponatremia, hypercalcemia, worsens or precipitates gout,
lipid abnormali es (elevated cholesterol and triglycerides), pancrea s, rash, photosensi vity,
erec le dysfunc on
