OXY 2 (Finals)

hypertension

persistently elevated blood pressure in the arteries

aka silent killer

140/90 or 130/80

2025 AHA/ACC guidelines define hypertension as BP____________

cardiac output x systemic vascular resistance

core formula of blood pressure

stage 1 hypertension

SBP 130-139 or DBP 80-89

lifestyle changes + medication

10-year ASCVD risk guides therapy

Stage 2 hypertension

SBP 140 or DBP 90

Lifestyle changes + antihypertensive meds

Combination therapy

Hypertensive crisis

BP 180/20

No acute organ damage

oral meds, gradual reduction

Primary (Essential)

most common

no single identifiable cause

Due to interplay of genetics, lifestyle, aging, SNS/RAAS overactivity, renal sodium retention

secondary HTN

due to identifiable disorder (renal disease, primary alsosteronism, pheochromocytoma, sleep apnea, drugs)

suspect in young, resistance, or abrupt-onset HTN

Isolated systolic/ white-coat/ masked

Isolated systolic (140) DBP (<90)

requires ambulatory monitoring for confirmation

white-coat

elevated in clinic only

masked

normal in clinic, elevated at home

Resistant

BP uncontrolled on >3 drugs including a diuretic

primary aldosteronism

key cause in resistant HTN cases

aldosteronism

adrenal aldosterone excess

ACE inhibitors, ARBs

first line agents for hypertension

Diuretics

reduces blood volume and vascular resistance

clorthalidone

preferred for longer half-life

calcium channel blockers

blocks calcium entry into vascular smooth muscle and cardiac cells

beta blockers

reduces heart rate and contractility