Hypertension Management Guidelines

Flashcards covering key concepts from the lecture notes on hypertension, including definitions, classifications, management strategies, and related conditions.

Normal Blood Pressure

Elevated Blood Pressure

120 to 129 mm Hg systolic and <80 mm Hg diastolic

Stage 1 Hypertension

130 to 139 mm Hg systolic or 80 to 89 mm Hg diastolic

Stage 2 Hypertension

≥140 mm Hg systolic or ≥90 mm Hg diastolic

Severe Hypertension (in nonpregnant individuals)

Blood pressure >180/120 mm Hg without evidence of acute target organ damage

Multidisciplinary Team-Based Care

An effective approach involving physicians, pharmacists, nurse practitioners, and other healthcare professionals to address patient needs and reduce barriers to hypertension control.

Lifestyle Changes for Hypertension Prevention/Treatment

Maintaining a healthy weight, following a heart-healthy diet (like DASH), reducing sodium intake, increasing dietary potassium, moderate physical activity, stress management, and reducing/eliminating alcohol intake.

PREVENT™ (Predicting Risk of CVD EVENTs)

A risk prediction tool recommended by AHA/ACC to estimate 10-year risk for cardiovascular disease, applicable to adults aged 30 to 79 years.

Hypertensive Emergencies

Severe elevations in BP (>180/120 mm Hg) associated with evidence of acute target organ damage, demanding immediate reduction of BP.

White-Coat Hypertension

Elevated blood pressure measurements in a clinical setting that are normal outside of the office setting for individuals not taking antihypertensive medication.

Masked Hypertension

Normal blood pressure measurements in a clinical setting that are elevated outside of the office setting for individuals not taking antihypertensive medication.

Resistant Hypertension

Blood pressure above goal despite treatment with 3 antihypertensive medications with complementary mechanisms of action, including a diuretic at maximally tolerated doses, or BP at goal but requiring ≥4 medications.

Renal Denervation (RDN)

An adjunct treatment option in carefully selected patients with resistant hypertension, involving a procedure to reduce blood pressure.

Primary Aldosteronism

A group of disorders where aldosterone production is inappropriately high, leading to intravascular volume expansion, suppressed plasma renin activity, sodium retention, increased potassium excretion, hypertension, and cardiovascular/kidney damage.

Obstructive Sleep Apnea (OSA)

A chronic condition characterized by recurring upper airway obstruction during sleep, resulting in hypoxia and disrupted sleep, and associated with an increased risk of hypertension.

Spironolactone

An MRA (mineralocorticoid receptor antagonist) recommended as a fourth drug for uncontrolled resistant hypertension.

Thiazide-type Diuretics

A class of antihypertensive agents (including hydrochlorothiazide, chlorthalidone, and indapamide) recommended as first-line therapy to prevent CVD.

Angiotensin-Converting Enzyme Inhibitors (ACEi) / Angiotensin Receptor Blockers (ARB)

First-line antihypertensive agents, particularly recommended in patients with diabetes and CKD (eGFR <60 mL/min/1.73 m2 or albuminuria ≥30 mg/g) to delay progression of diabetes-related kidney disease.

Calcium Channel Blockers (CCB)

Long-acting dihydropyridine CCBs are recommended as first-line therapy to prevent CVD.

Home Blood Pressure Monitoring (HBPM)

A valuable tool to obtain out-of-office BP measurements over days to weeks, enhancing accuracy and precision for detecting a patient's true BP levels and monitoring medication titration.

Cuffless BP Devices

Devices for measuring blood pressure without a cuff (e.g., smartwatches), currently not recommended for diagnosis or management of high BP due to insufficient precision and reliability.

Gestational Hypertension

De novo development of hypertension after 20 weeks' gestation in the absence of new proteinuria or target organ damage.

Preeclampsia

A multiorgan system inflammatory syndrome in pregnancy characterized by hypertension, proteinuria, or other maternal end-organ dysfunction.