HTN & Lipidemia (Part I)

Vocabulary practice flashcards covering diagnostic thresholds, pathophysiology, disease classifications, clinical presentations, and management of hypertension and dyslipidemia.

Blood Pressure (BP)

The arterial pressure calculated as cardiac output multiplied by systemic vascular resistance

($\text{BP} = \text{CO} \times \text{SVR}$ )

Systolic Blood Pressure (SBP)

The pressure in the arterial system when the ventricles are contracted in systole, ejecting blood into peripheral vessels.

Diastolic Blood Pressure (DBP)

The pressure in the arterial system when the ventricles are relaxed in diastole.

Normal Blood Pressure

A blood pressure classification defined as a systolic pressure $< 120\,\text{mmHg}$ and a diastolic pressure $< 80\,\text{mmHg}$.

Elevated Blood Pressure

A blood pressure classification defined as a systolic pressure of $120\text{--}129\,\text{mmHg}$ and a diastolic pressure $< 80\,\text{mmHg}$.

Stage 1 Hypertension

A blood pressure classification defined as a systolic pressure of $130\text{--}139\,\text{mmHg}$ or a diastolic pressure of $80\text{--}89\,\text{mmHg}$.

Stage 2 Hypertension

A blood pressure classification defined as a systolic pressure $\ge 140\,\text{mmHg}$ or a diastolic pressure $\ge 90\,\text{mmHg}$.

White Coat Hypertension

A condition in which blood pressure readings are elevated in the clinical office setting due to stress or anxiety but remain normal during out-of-office home monitoring.

Masked Hypertension

A condition in which a patient's blood pressure is normal in the clinical office but elevated or very elevated during home or ambulatory monitoring.

Primary (Essential) Hypertension

Hypertension without a single identifiable underlying cause, accounting for approximately $90\%$ of cases, with onset typically between $25$ and $50$ years of age.

Secondary Hypertension

Hypertension that is secondary to an identifiable underlying condition, anatomical change, medication, or substance exposure, accounting for $5\text{--}10\%$ of cases.

Renovascular Stenosis

A cause of secondary hypertension characterized by narrowing of the renal arteries, which often presents clinically with abdominal bruits and elevated serum creatinine.

Pheochromocytoma

An endocrine tumor producing ectopic epinephrine and norepinephrine that causes secondary hypertension and manifests with episodic headaches, palpitations, and diaphoresis.

First-Line Antihypertensive Classes

4 guideline-recommended initial medication classes for HTN:

Thiazide-type diuretics

ACE inhibitors

ARBs

Dihydropyridine calcium channel blockers (DHPs)

ACE Inhibitors

Antihypertensive agents ending in '-pril' that decrease angiotensin II production; notable adverse effects include chronic dry cough and contraindication during pregnancy.

Angiotensin Receptor Blockers (ARBs)

Renoprotective antihypertensives ending in '-sartan' that block AT1 receptors without causing cough; strictly contraindicated during pregnancy.

Severe Hypertension Without Acute Target Organ Damage

Marked blood pressure elevation ($\ge 180/120\,\text{mmHg}$) without evidence of acute injury to the brain, heart, aorta, or kidneys (formerly termed hypertensive urgency).

Hypertensive Emergency

Severe blood pressure elevation accompanied by acute target organ damage, requiring ICU admission and titratable intravenous antihypertensive therapy.

Malignant Hypertension

A severe form of hypertensive emergency in which encephalopathy or nephropathy is accompanied by hypertensive retinopathy.

Initial MAP Reduction Goal (Hypertensive Emergency)

A controlled reduction of mean arterial pressure (MAP) by no more than $25\%$ within the first hour of treatment to avoid cerebral, renal, or coronary ischemia.

Posterior Reversible Encephalopathy Syndrome (PRES)

A central nervous system complication of severe hypertension presenting with altered mental status, visual changes, or seizures.

Foam Cells

Immature atherosclerotic plaque components formed when monocytes differentiate into macrophages and engulf oxidized lipoprotein particles within the damaged arterial intima.

Stable Plaque

An atherosclerotic lesion with a lipid core covered by a fibrous cap of smooth muscle and matrix that produces fixed luminal narrowing and exertional ischemia/claudication.

Ruptured Plaque

An eroded or ruptured atherosclerotic lesion that exposes its core, initiating platelet activation and thrombosis, leading to acute coronary syndrome or tissue ischemia.

Low-Density Lipoprotein (LDL)

Cholesterol-rich, ApoB-containing lipoprotein particles that deposit into the arterial intima and represent the most atherogenic driver of cardiovascular disease.

High-Density Lipoprotein (HDL)

Liver-derived lipoprotein responsible for reverse cholesterol transport back from peripheral vessels; functions as a cardioprotective risk marker rather than a direct treatment target.

Severe Hypercholesterolemia

A lipid panel finding defined by an LDL-C level $\ge 190\,\text{mg/dL}$ , warranting immediate statin therapy and evaluation for familial history.

Hypertriglyceridemic Pancreatitis Threshold

Triglyceride levels $\ge 500\,\text{mg/dL}$ (and especially $\ge 1000\,\text{mg/dL}$), which dramatically elevate the risk for developing acute pancreatitis.

Xanthelasma

Yellow cholesterol-rich deposits that develop in the skin around the eyelids.

Tendon Xanthomas

Fatty cholesterol deposits that localize within tendons, most commonly the Achilles, patellar, or extensor tendons of the hand.

Eruptive Xanthomas

Discrete red-yellow papules appearing on extensor surfaces and buttocks caused by markedly elevated chylomicrons or very low-density lipoproteins (VLDL).

Lipemia Retinalis

A physical exam finding characterized by a creamy, pale appearance of retinal blood vessels observed at extremely high serum triglyceride concentrations.

Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD)

Hepatic steatosis accompanied by one or more cardiometabolic risk factors without other causes; previously designated as nonalcoholic fatty liver disease (NAFLD).

Clinical ASCVD (ASCVD)

A history of documented atherosclerotic cardiovascular disease, including acute coronary syndrome, prior MI, stable/unstable angina, revascularization, stroke/TIA, or peripheral arterial disease.

High-Intensity Statins

Statin regimens (specifically atorvastatin and rosuvastatin) capable of lowering baseline LDL-C levels by $\ge 50\%$.

Ezetimibe

An oral non-statin lipid-lowering medication that selectively targets LDL cholesterol absorption, lowering LDL-C levels by approximately $17\%$.

PREVENT Algorithm

A cardiovascular risk assessment tool known as CPR:

C: Calculate 10-year ASCVD risk)

P: Personalize with risk enhancers)

R: Reclassify using coronary artery calcium).