Hypertension and JNC 7/8 Guidelines Flashcards
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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?

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

    What is the initial drug therapy recommended for most hypertension?

    <p>Thiazide-type diuretics</p> Signup and view all the answers

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

    <p>Two or three</p> Signup and view all the answers

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

    <p>Systolic &lt; 120 mmHg AND Diastolic &lt; 80 mmHg</p> Signup and view all the answers

    According to JNC 7, what defines pre-hypertension?

    <p>Systolic 120-139 mmHg OR Diastolic 80-89 mmHg</p> Signup and view all the answers

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

    <p>Systolic 140-159 mmHg OR Diastolic 90-99 mmHg</p> Signup and view all the answers

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

    <p>Systolic &gt;= 160 mmHg OR Diastolic &gt;= 100 mmHg</p> Signup and view all the answers

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

    <p>Beta Blockers</p> Signup and view all the answers

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

    <p>Isolated Systolic HTN</p> Signup and view all the answers

    What is the classification for Malignant Hypertension?

    <p>Systolic &gt;= 200 mmHg AND Diastolic &gt;= 140 mmHg</p> Signup and view all the answers

    What is hypertension without an identifiable cause?

    <p>Primary or essential hypertension</p> Signup and view all the answers

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

    <p>Secondary Hypertension</p> Signup and view all the answers

    What is the prevalence of hypertension in the United States?

    <p>67 million</p> 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?

    <p>1 premature death</p> Signup and view all the answers

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

    <p>53.5%</p> Signup and view all the answers

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

    <p>38.4%</p> Signup and view all the answers

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

    <p>15.8%</p> Signup and view all the answers

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

    <p>44.8%</p> Signup and view all the answers

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

    <p>+/- 20 mmHg</p> Signup and view all the answers

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

    <p>White coat hypertension</p> Signup and view all the answers

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

    <p>Ambulatory BP measurement</p> Signup and view all the answers

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

    <p>Lower</p> Signup and view all the answers

    How much does blood pressure usually drop during the night?

    <p>10-20%</p> Signup and view all the answers

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

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

    With a home measurement device, what is considered hypertensive?

    <p>135/85 mmHg</p> Signup and view all the answers

    What are risk factors for cardiovascular disease (CVD)?

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

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

    <p>Sleep Apnea</p> Signup and view all the answers

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

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

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

    <p>Stroke, Transient Ischemic Attack (TIA)</p> Signup and view all the answers

    What are indicated tests for hypertension?

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

    BP should be less than _____

    <p>140/90</p> 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).

    • 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.

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