| A | B |
|---|
| normal bp | <120/<80 |
| pre htn | 120-139/80-89 |
| HTN STage 1 | 140-159/90-99 |
| HTN STage 2 | >160/>100 |
| Primary htn | nio identifiable cause, older, AFrican Americans, obese people, lifelong |
| Secondary htn | identifiable cause, i.e 4% renal dz, renovascular dz, coarctation of aorta, primary aldoesteronism, ocp's |
| Consequences of htn | heart disease, angina, MI, kidney diseaese, stroke, |
| target goals | <140/90 |
| diabetic target goals | <130/80 |
| lifestyle modifications for HTN | low salt, low alcohol, low calorie, maintain potassium |
| arterial bp= | cardiac output x PR |
| heart rate, myocardial contractility, blood volume & venous return determine | cardiac output |
| systems that regulate bp | sympathetic barorectptor reflex, renin/angiotension/aldosterone sytem, renal regulation of bp |
| sympathetic barorectptor reflex | feedback system where low bp causes activation of a1pha 2 beta 1 receptors, which increases hr and vasocontriction |
| renin/angiotension/aldosterone system | feedback system where reduced blood flow to kidneys or reduced bp causes release of renin, which converts angiotension 1 to 2, which results in increased bp and increased pvr, also stimulates aldosterone release from renal cortex |
| how ace inhibitors work | prevent conversion of angiotension 1 to 2 |
| how beta blcokers work | used to suppress renin release |
| ARB's (angiotension receptor blockers) work by | blocking angiotensin 2 receptors |
| adlosterone antagonists | block aldosterone receptors |
| when bp falls.... | gfr falls, thereby promoting retention of sodium & water |
| examples of diuretics | thiazides, loop and potassium sparing |
| examples of sympatholytics | beta blockers, alpha 1 blockers, alpha/beta blockers (carevedilol & labetolol), centrally acting alpha 2 agonists, adrenergic neuron blockers |
| examples of direct acting vasodilators | hydralazine, minoxidil |
| exmaples of calcium chaneel blockers | dihydropyridines & non dihydropyridines |
| ways to promote adherence | educate pt., teach self monitoring, simplify regimen, control side effetcts |
| drugs for htn emergencies | sodium nitroprusside, dyazoxide, fenodoplam, labetolol |
| anti hypertensive med to avoid in AFrican American | ACE inhibors (cause rashes in AFrican Americans) |
| htn meds for diabetics | ACE I or ARB |
| htn med for pt. with also edema | diuretic |
| htn med for pt. with tachycardic | beta blocker or non dihydropyridine calcium channel blockers |
| htn med for pt. with history of MI/CAD | beta blockers |
| htn pt. with CHF | ACE inhibitor, diuretics |
| htn. pt. with asthma: avoid | beta blockers |
| htn. pt. wtih diabeties: avoid | maybe beta blockers |
| htn pt. getting allergy shots | avoid beta blockers |
| htn pt. with bradcardia: avoid | beta blockers or non dihydropyridine calcium channel blockers |
| htn. pt with bundle branch block | avoid beta blockers or non dihyrdopyridine calcium channel blockers |
| drug of choice for preeclampsia | hydralazine |
| meds to avoid in sexually active female teens | ACE Inhibitors & ARBs |
