Hypertension and JNC 7/8 Guidelines Flashcards

Questions and Answers

According to JNC 7, which blood pressure is more important as a risk factor for CVD?

Diastolic Blood Pressure

Systolic Blood Pressure (correct)

According to JNC 7, starting at what blood pressure does the risk of CVD double for every increase in 20/10 mmHg?

115/75 mmHg

According to JNC 7, what percent chance do normotensive people at age 55 have of developing HTN during their lifetime?

90%

According to JNC 7, what blood pressure range should be considered pre-hypertensive?

120-139/80-89 mmHg Signup and view all the answers

What is the initial drug therapy recommended for most hypertension?

Thiazide-type diuretics Signup and view all the answers

How many anti-hypertensive drugs will most patients require to achieve their goal blood pressure?

Two or three Signup and view all the answers

According to JNC 7, what is the classification for normal blood pressure?

Systolic < 120 mmHg AND Diastolic < 80 mmHg Signup and view all the answers

According to JNC 7, what defines pre-hypertension?

Systolic 120-139 mmHg OR Diastolic 80-89 mmHg Signup and view all the answers

According to JNC 7, what is the classification for Stage 1 Hypertension?

Systolic 140-159 mmHg OR Diastolic 90-99 mmHg Signup and view all the answers

According to JNC 7, what is the classification for Stage 2 Hypertension?

Systolic >= 160 mmHg OR Diastolic >= 100 mmHg Signup and view all the answers

What is the main difference between JNC 7 and 8 regarding initial drug treatment?

Beta Blockers Signup and view all the answers

What is the diagnosis for Systolic > 140 mmHg AND Diastolic = 140 mmHg OR Diastolic >= 99 mmHg?

Isolated Systolic HTN Signup and view all the answers

What is the classification for Malignant Hypertension?

Systolic >= 200 mmHg AND Diastolic >= 140 mmHg Signup and view all the answers

What is hypertension without an identifiable cause?

Primary or essential hypertension Signup and view all the answers

What is hypertension caused by something (i.e. renovascular, endocrine, neurologic, toxic, or gestational)?

Secondary Hypertension Signup and view all the answers

What is the prevalence of hypertension in the United States?

67 million Signup and view all the answers

What is the number of premature deaths prevented for stage 1 hypertension with associated CVD risk factors for every 11 patients treated?

1 premature death Signup and view all the answers

What percentage of those that have hypertension do not have it controlled?

53.5% Signup and view all the answers

What percentage of those that do not know they have hypertension?

38.4% Signup and view all the answers

What percentage of those that know they have hypertension but are not taking medications for it?

15.8% Signup and view all the answers

What percentage of those that know they have hypertension and are taking medications for it?

44.8% Signup and view all the answers

What is the standard deviation for an OTC automatic instrument measuring blood pressure?

+/- 20 mmHg Signup and view all the answers

What is elevated blood pressure when measured in a medical office but normal in out-of-office settings?

White coat hypertension Signup and view all the answers

What is warranted for an elevation of 'white coat' hypertension in the absence of a target organ?

Ambulatory BP measurement Signup and view all the answers

Are ambulatory BP values usually higher or lower than clinic readings?

Lower Signup and view all the answers

How much does blood pressure usually drop during the night?

10-20% Signup and view all the answers

What kind of information does self-measurement of blood pressure provide?

Response to anti-hypertensive therapy, Improving adherence with therapy, Evaluating white-coat hypertension Signup and view all the answers

With a home measurement device, what is considered hypertensive?

135/85 mmHg Signup and view all the answers

What are risk factors for cardiovascular disease (CVD)?

Hypertension, Obesity, Dyslipidemia, Diabetes Mellitus, Family History of premature CVD (men under age 55 or women under age 65) Signup and view all the answers

What is an identifiable cause of hypertension that 50% of people with heart disease have?

Sleep Apnea Signup and view all the answers

What are damages to the heart that can be caused by hypertension?

Left Ventricle hypertrophy, Angina or prior myocardial infarction, Prior coronary revascularization, Heart failure Signup and view all the answers

What are damages to the brain that can be caused by hypertension?

Stroke, Transient Ischemic Attack (TIA) Signup and view all the answers

What are indicated tests for hypertension?

Electrocardiogram, Urinalysis, Blood glucose and hematocrit, Serum K+, Creatinine, Ca2+, Lipid Profile Signup and view all the answers

BP should be less than _____

140/90 Signup and view all the answers

Study Notes

Hypertension and JNC Guidelines

Systolic Blood Pressure: Identified as a more critical risk factor for cardiovascular disease (CVD) than diastolic pressure according to JNC 7.
CVD Risk Increase: Starting at a blood pressure of 115/75 mmHg, the risk of CVD doubles with every increase of 20/10 mmHg.
Lifetime HTN Risk: 90% of normotensive individuals at age 55 are likely to develop hypertension during their lifetime.
Pre-hypertensive Range: Blood pressure readings of 120-139 systolic and 80-89 diastolic mmHg categorize individuals as pre-hypertensive.
Initial Drug Therapy: Thiazide-type diuretics are recommended as the first-line treatment for most cases of hypertension.
Medication Requirements: Most patients require two or three antihypertensive drugs to reach their target blood pressure.

Blood Pressure Classifications

Normal BP: Defined as systolic < 120 mmHg and diastolic < 80 mmHg.
Pre-hypertension: Defined as systolic between 120-139 mmHg or diastolic between 80-89 mmHg.
Stage 1 Hypertension: Classified as systolic 140-159 mmHg or diastolic 90-99 mmHg.
Stage 2 Hypertension: Classified as systolic ≥ 160 mmHg or diastolic ≥ 100 mmHg.

Differences in Guidelines

Beta Blockers Exclusion: JNC 8 did not include beta blockers as a recommended initial drug treatment for hypertension.

Hypertension Types

Isolated Systolic Hypertension: Characterized by systolic > 140 mmHg with diastolic ≤ 90 mmHg.
Malignant Hypertension: Defined as systolic ≥ 200 mmHg and diastolic ≥ 140 mmHg, often with serious complications.
Primary Hypertension: Refers to hypertension without an identifiable cause.
Secondary Hypertension: Hypertension linked to identifiable causes such as renal, endocrine, neurological factors, or pregnancy.

Prevalence and Awareness

HTN Prevalence: Approximately 67 million people in the United States are affected by hypertension.
Untreated HTN: 53.5% of individuals with hypertension do not have their condition under control.
Unawareness of HTN: About 38.4% of people with hypertension are unaware of their condition.
Non-compliance: 15.8% of individuals diagnosed with hypertension are not taking any medications.
Treatment with Medication: 44.8% of those who know they have hypertension are currently on medication.

Monitoring Blood Pressure

Measurement Variability: The standard deviation for OTC automatic blood pressure measurement is ± 20 mmHg.
White Coat Hypertension: Elevated blood pressure in a clinical setting, normal readings outside the office suggest a need for further evaluation.
Ambulatory Measurement: Recommended for cases of "white coat" hypertension without target organ damage.
Pressure Comparison: Ambulatory blood pressure is typically lower than clinic measurements.
Nighttime BP Drop: Blood pressure usually drops by 10-20% during the night.

Benefits of Self-Measurement

Self-Monitoring Insights: Provides valuable information on response to antihypertensive therapy, adherence to treatment, and assessment of white coat hypertension.
Home Measurement Threshold: A reading of 135/85 mmHg is considered hypertensive when measured at home.

Risk Factors for Cardiovascular Disease

CVD Risk Factors: Include hypertension, obesity, dyslipidemia, diabetes mellitus, and a family history of premature CVD (men under 55, women under 65).
Sleep Apnea Association: Sleep apnea is a common identifiable cause of hypertension, present in about 50% of patients with heart disease.

Health Impacts of Hypertension

Heart Damage: Conditions linked to hypertension include left ventricular hypertrophy, angina, prior myocardial infarction, coronary revascularization, and heart failure.
Brain Damage: Hypertension is a risk factor for stroke and transient ischemic attacks (TIA).

Recommended Tests for Hypertension

Indicated Diagnostic Tests: Include electrocardiograms, urinalysis, blood glucose, hematocrit, serum potassium, creatinine, calcium levels, and lipid profiles.

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Description

Test your knowledge on hypertension concepts outlined in the JNC 7 and JNC 8 guidelines. This quiz features essential definitions and risk factors related to blood pressure measurements. Perfect for medical students or healthcare professionals looking to brush up on cardiovascular disease risk factors.