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AM - CARDIOVASCULAR DISEASES

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tonystep1's version from 2017-08-17 03:37

CAUSES OF HYPERTENSION

Question Answer
Renal vascular diseaserenal artery stenosis (most common cause of secondary HTN) // chronic renal failure // polycystic kidneys
Endocrine causescauses-hyperaldosteronism, thyroid or parathyroid disease, Cushing's syndrome, pheochromocytoma, hyperthyroidism, acromegaly
Medicationsoral contraceptives, decongestants, estrogen, appetite suppressants, chronic steroids, tricyclic antidepressants (TCAs), nonsteroidal antiinflammatory drugs (NSAlDs) // cocaine
Obstructive lung diseaseSleep Apnea
Cardiac causesCoartaction of the Aorta
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HYPERTENSIVE COMPLICATIONS

Question Answer
Cardiovascular systemCHF is a common end-result of untreated HTN as LVH occurs. // HTN predisposes the patient to peripheral vascular disease (PVD). // HTN is associated with increased incidence of aortic dissection
Eyes (retinal changes)Arteriovenous nicking and cotton wool spots - can cause visual disturbances and scotomata // hemorrhages and exudates // Papilledema-an ominous finding seen with severely elevated BP
CNSIncreased incidence of intracerebral hemorrhage // Increased incidence of other stroke subtypes as well (transient ischemic attacks [TIAs] , ischemic stroke, and lacunar stroke) // Hypertensive encephalopathy when BP is severely elevated (uncommon)
KidneyArteriosclerosis of afferent and efferent arterioles and glomerulus-called nephrosclerosis // Decreased GFR and dysfunction of tubules-with eventual renal failure
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Classification and Management of Hypertension

Question Answer
Normal< 120 / <80
Pre-Hypertensive120-139 / 80-89 // Life style modification
Stage I140-159 / 90-99 // Life style modification , drug therapy
Stage IIgreater than 160 systolic or 100 diastolic // Life style modification , 2-drug therapy
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Treatment of Hypertension

Question Answer
Lifestyle changesreduce salt intake // lose weight // avoid excessive alcohol consumption // Exercise regularly // Follow a low saturated fat diet rich in fruits , vegetables, and low fat dairy products // stop unneccessary medications which contribute to HTN // Engage in appropriate stress management practices.
Preferred drug in all diabetic patientsACE inhibitors
typically given in combination with {3-blockers and diuretics to patients with refractory HTNVasodilators (hydralazine and minoxidil)-
typically given to "salt-sensitive" HTNThiazides
Pharmacological classesThiazides // beta blockers // ACE inhibitors // ARBs // Calcium channel blockers // Vasodilators
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