NAPLEX: Hypertension| Ques ons and answers |
Updated RATED A+
What can uncontrolled hypertension lead to?
Increased risk for heart disease, stroke and kidney disease.
What kind of hypertension is most common?
Primary/Essen al Hypertension
-The cause in unknown, but a combina on of risk factors
What is Secondary Hypertension?
Elevated BP with a specific cause such as:
- Renal disease
- Adrenal disease
- Obstruc ve sleep apnea
- Some drugs
What is the mechanism of hypertension?
Increased ac vity of sympathe c nervous system (SNS) and the renin-angiotensin-aldosterone
system (RAAS) which leads to increased levels of neurohormones that increase the blood
pressure
How should BP readings be taken?
Based on an average of at least two readings taken from two separate occasions, preferably
standardized to the ming of medica on administra on
What are the four categories of BP as defined by the ACC/AHA?
1. Normal: SBP <120 and DBP <80
2. Elevated: SBP 120-129 and DBP <80
3. Hypertension Stage 1: SBP 130-139 OR DBP 80-89
4. Hypertension Stage 2: SBP ≥140 OR DBP ≥90
Do's and Don'ts of Self-BP Monitoring
, Do:
1. Go to the restroom and empty the bladder
2. Sit in a chair with both feet on the floor and relax for 5 minutes
3. Use the correct cuff size
4. Support the arm at heart level
5. Wait 1-2 minutes in between measurements
Don't:
1. Talk
2. Sit or lie down
3. Drink caffeine, exercise or smoke 30 minutes prior
4. Use a finger or wrist monitor (less accurate)
What are some lifestyle management recommenda ons for pa ents with HTN?
1. Weight loss (1kg of weight loss can decrease BP by ~1mmHg)
2. Heart-healthy diet (such as DASH), high in fruits, vegetables, fiber and low-fat dairy products.
Low saturated fats and sugars
3. Adequate dietary potassium or supplementa on unless CI
4. Reduced sodium intake <1,500mg daily
5. Tobacco cessa on
6. Limi ng alcohol to one drink daily for women or 2 for men
7. Controlling blood glucose and cholesterol
What natural products have some evidence at reducing blood pressure?
1. Fish oil
2. Coenzyme Q10
3. L-arginine
4. Garlic
General HTN treatment guidelines given by ACC/AHA
1. Emphasize lifestyle modifica ons
2. Once-daily medica ons are preferred for medica on adherence
3. 4 preferred drug classes for ini al treatment/ tra on which are ACEi, ARBs, DHP CCBs and
thiazide diure cs
4. Most pa ents require two or more drugs
5. When tra ng medica ons, adding a second med before increasing to max dose can be more
effec ve and cause less ADRs
When should HTN treatment be started?
Updated RATED A+
What can uncontrolled hypertension lead to?
Increased risk for heart disease, stroke and kidney disease.
What kind of hypertension is most common?
Primary/Essen al Hypertension
-The cause in unknown, but a combina on of risk factors
What is Secondary Hypertension?
Elevated BP with a specific cause such as:
- Renal disease
- Adrenal disease
- Obstruc ve sleep apnea
- Some drugs
What is the mechanism of hypertension?
Increased ac vity of sympathe c nervous system (SNS) and the renin-angiotensin-aldosterone
system (RAAS) which leads to increased levels of neurohormones that increase the blood
pressure
How should BP readings be taken?
Based on an average of at least two readings taken from two separate occasions, preferably
standardized to the ming of medica on administra on
What are the four categories of BP as defined by the ACC/AHA?
1. Normal: SBP <120 and DBP <80
2. Elevated: SBP 120-129 and DBP <80
3. Hypertension Stage 1: SBP 130-139 OR DBP 80-89
4. Hypertension Stage 2: SBP ≥140 OR DBP ≥90
Do's and Don'ts of Self-BP Monitoring
, Do:
1. Go to the restroom and empty the bladder
2. Sit in a chair with both feet on the floor and relax for 5 minutes
3. Use the correct cuff size
4. Support the arm at heart level
5. Wait 1-2 minutes in between measurements
Don't:
1. Talk
2. Sit or lie down
3. Drink caffeine, exercise or smoke 30 minutes prior
4. Use a finger or wrist monitor (less accurate)
What are some lifestyle management recommenda ons for pa ents with HTN?
1. Weight loss (1kg of weight loss can decrease BP by ~1mmHg)
2. Heart-healthy diet (such as DASH), high in fruits, vegetables, fiber and low-fat dairy products.
Low saturated fats and sugars
3. Adequate dietary potassium or supplementa on unless CI
4. Reduced sodium intake <1,500mg daily
5. Tobacco cessa on
6. Limi ng alcohol to one drink daily for women or 2 for men
7. Controlling blood glucose and cholesterol
What natural products have some evidence at reducing blood pressure?
1. Fish oil
2. Coenzyme Q10
3. L-arginine
4. Garlic
General HTN treatment guidelines given by ACC/AHA
1. Emphasize lifestyle modifica ons
2. Once-daily medica ons are preferred for medica on adherence
3. 4 preferred drug classes for ini al treatment/ tra on which are ACEi, ARBs, DHP CCBs and
thiazide diure cs
4. Most pa ents require two or more drugs
5. When tra ng medica ons, adding a second med before increasing to max dose can be more
effec ve and cause less ADRs
When should HTN treatment be started?
