Hypertension Diagnosis and Treatment Quiz

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Questions and Answers

What is the primary reason for taking hypertension medication even if the patient does not feel any symptoms?

To prevent complications associated with hypertension (correct)

To immediately lower blood pressure

To improve overall well-being

To alleviate symptoms of hypertension

Which class of anti-hypertensive agents acts by directly dilating blood vessels?

RAA inhibitors

Diuretics

Direct vasodilators (correct)

Sympathoplegic drugs

What is the main therapeutic objective in treating hypertension?

To reduce the risk of cardiovascular complications (correct)

To immediately lower blood pressure

To eliminate all symptoms of hypertension

To normalize all physiological parameters

What is the mechanism of action of ACE inhibitors?

Inhibition of ACE leads to decreased angiotensin II synthesis and arteriolar vasodilation Signup and view all the answers

Which side effect is commonly associated with direct vasodilators like Hydralazine and Minoxidil?

Fluid retention and lupus-like syndrome Signup and view all the answers

Which drug is an example of a direct renin inhibitor?

Aliskiren Signup and view all the answers

What is the mechanism of action of ARBs (Angiotensin II Receptor Blockers)?

Blocks the binding of angiotensin II to smooth muscle receptors, leading to arteriolar vasodilation Signup and view all the answers

Which condition is a contraindication for the use of spironolactone?

Hyperkalemia Signup and view all the answers

True or False: Dihydropyridines cause vasoconstriction.

False Signup and view all the answers

True or False: ACE inhibitors and ARBs are more effective in reducing proteinuria than other antihypertensive agents.

True Signup and view all the answers

Which side effect is specifically associated with ACE inhibitors and ARBs?

Cough and angioedema Signup and view all the answers

What is the mechanism of action of spironolactone?

Promotes sodium and water excretion in the renal tubules Signup and view all the answers

Which condition is a contraindication for the use of Aliskiren?

Hyperkalemia Signup and view all the answers

What is the usual dose for Captopril?

25 mg BID Signup and view all the answers

How is hypertension diagnosed?

Based on blood pressure measurement, not patient-reported symptoms Signup and view all the answers

What blood pressure measurements constitute hypertension according to ISH guidelines?

Systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg Signup and view all the answers

How many office visits are typically required to confirm the diagnosis of hypertension?

2-3 visits at 1-4 week intervals Signup and view all the answers

What does masked hypertension refer to?

Normal BP in the clinic but elevated BP at home Signup and view all the answers

What is the correlation between increase in office BP and cardiovascular events?

Increase in office BP correlates with incidence of cardiovascular events Signup and view all the answers

How do international guidelines compare in relation to hypertension?

International guidelines closely follow the European guideline compared to the American guideline Signup and view all the answers

What percentage of patients have specific causes of hypertension established?

10-15% Signup and view all the answers

What does high-normal BP serve as?

A warning sign for potential hypertension Signup and view all the answers

What is the effect of effective pharmacological lowering of BP?

Prevents vessel damage and reduces morbidity and mortality Signup and view all the answers

Where does hypertension cause damage to blood vessels?

In the kidney, heart, and brain Signup and view all the answers

What is the classification of hypertension based on?

Various sources, including JNC, ESC/ESH, ACC/AHA, and ISH Signup and view all the answers

What is the risk associated with masked hypertension?

Requires confirmation with repeated measurements and carries similar CV event risk as sustained hypertension Signup and view all the answers

Which type of medication can increase blood pressure and blunt the effect of antihypertensives?

NSAIDs (except aspirin) Signup and view all the answers

Which class of drugs are sympathoplegic and decrease sympathetic influence on the heart by blocking β receptors?

β-blockers Signup and view all the answers

Which medication is a centrally-acting α2 agonist that acts on the α-receptors in the brainstem to decrease blood pressure?

Clonidine Signup and view all the answers

Which class of drugs includes α1-blockers, calcium channel blockers, and other vasodilators for severe hypertension?

Direct vasodilators Signup and view all the answers

What is a major side effect of β-blockers?

Bradycardia Signup and view all the answers

Which side effect is associated with centrally-acting α2 agonists like clonidine and methyldopa?

Sedation Signup and view all the answers

Which type of drugs are vasoconstrictors and directly negate the effects of antihypertensives?

Decongestants Signup and view all the answers

Which class of drugs are known to negate the effects of antihypertensives, except for aspirin?

NSAIDs Signup and view all the answers

Which type of drugs are recommended to be combined from different classes for hypertension treatment?

Antihypertensives Signup and view all the answers

Which class of drugs are considered as direct vasodilators for severe hypertension?

Direct vasodilators Signup and view all the answers

Which type of drugs are sympathoplegic and decrease sympathetic influence on the heart by blocking β receptors?

β-blockers Signup and view all the answers

What is White Coat Hypertension?

Elevated blood pressure during doctor's visits Signup and view all the answers

What is the primary purpose of confirming hypertension diagnosis with repeated blood pressure measurements?

To rule out White Coat Hypertension Signup and view all the answers

What factors affect blood pressure?

Cardiac output and peripheral vascular resistance Signup and view all the answers

What is the effect of vasoconstriction on peripheral vascular resistance and blood pressure?

Increases PVR and blood pressure Signup and view all the answers

What is the role of the kidney in regulating intravascular fluid volume?

Through the Renin-Angiotensin-Aldosterone System (RAAS) Signup and view all the answers

Which antihypertensive agent acts by increasing venous return?

Leads to an increase in CO and blood pressure Signup and view all the answers

What is the primary effect of vasodilators on peripheral vascular resistance?

Decreases PVR Signup and view all the answers

Which classification of antihypertensive agents includes diuretics and sympathoplegic agents?

Antihypertensive agents with different mechanisms of action Signup and view all the answers

Why should drugs with the same mechanisms of action not be combined in hypertension treatment?

Due to compounded side effects Signup and view all the answers

What is the primary risk factor for not prescribing drug treatment for hypertension?

Low total cardiovascular risk Signup and view all the answers

What is the primary therapeutic target in treating hypertension?

Factors affecting blood pressure Signup and view all the answers

What is the primary effect of increasing venous return on blood pressure?

Leads to an increase in CO and blood pressure Signup and view all the answers

What is the primary reason for taking hypertension medication even if the patient does not feel any symptoms?

To prevent complications associated with hypertension Signup and view all the answers

Which class of anti-hypertensive agents acts by directly dilating blood vessels?

Direct renin inhibitors Signup and view all the answers

What is the main therapeutic objective in treating hypertension?

To prevent target organ damage Signup and view all the answers

Which factor affects blood pressure by increasing peripheral vascular resistance?

Vasoconstriction Signup and view all the answers

Which system regulates intravascular fluid volume and can increase blood pressure?

Renin-Angiotensin-Aldosterone System (RAAS) Signup and view all the answers

Which drug classification should not be combined in hypertension treatment due to compounded side effects?

Direct vasodilators Signup and view all the answers

What is the primary effect of increasing venous return on blood pressure?

Increase in cardiac output Signup and view all the answers

Which antihypertensive agent acts by decreasing sympathetic influence on the heart by blocking β receptors?

β-blockers Signup and view all the answers

What is the primary reason for not prescribing drug treatment if a patient's total cardiovascular risk is low and there is no hypertension-mediated organ damage?

Low potential benefit of medication Signup and view all the answers

What type of hypertension is characterized by elevated blood pressure during doctor’s visits but not in other settings?

White Coat Hypertension Signup and view all the answers

What is the effect of vasoconstriction on peripheral vascular resistance and blood pressure?

Increase in peripheral vascular resistance and blood pressure Signup and view all the answers

What is the primary therapeutic target in treating hypertension?

Reducing peripheral vascular resistance Signup and view all the answers

Which class of drugs are used as antihypertensive agents with different mechanisms of action?

Sympathoplegic agents Signup and view all the answers

What is the effect of decreasing venous return on cardiac output and blood pressure?

Decrease in cardiac output and blood pressure Signup and view all the answers

What is the classification of hypertension based on according to the ISH?

Office, ambulatory, and home blood pressure measurements Signup and view all the answers

Which class of drugs are vasoconstrictors and directly negate the effects of antihypertensives?

NSAIDs Signup and view all the answers

What is a major side effect of centrally-acting α2 agonists like clonidine and methyldopa?

Sedation Signup and view all the answers

What is the mechanism of action of calcium channel blockers?

Blocking calcium channels in arteriolar smooth muscles Signup and view all the answers

What is the primary therapeutic target in treating hypertension?

Decreasing peripheral vascular resistance Signup and view all the answers

What is the primary risk factor for not prescribing drug treatment for hypertension?

Age Signup and view all the answers

What is the classification of hypertension based on?

Blood pressure measurements Signup and view all the answers

What is the correlation between increase in office BP and cardiovascular events?

Strong positive correlation Signup and view all the answers

What is the primary effect of vasoconstriction on peripheral vascular resistance and blood pressure?

Increases peripheral vascular resistance and blood pressure Signup and view all the answers

What is the primary reason for taking hypertension medication even if the patient does not feel any symptoms?

All of the above Signup and view all the answers

What does high-normal BP serve as?

A risk factor for hypertension Signup and view all the answers

What is the role of the kidney in regulating intravascular fluid volume?

Maintaining fluid volume Signup and view all the answers

What is the effect of effective pharmacological lowering of BP?

Decreased risk of cardiovascular events Signup and view all the answers

Which of the following drugs is a direct renin inhibitor?

Aliskiren Signup and view all the answers

True or False: Dihydropyridines cause vasoconstriction.

False Signup and view all the answers

True or False: Propranolol, metoprolol, and atenolol are cardio-selective beta blockers.

False Signup and view all the answers

Which of the following drugs is a non-dihydropyridine calcium channel blocker?

Diltiazem Signup and view all the answers

Which of the following side effects is associated with direct vasodilators like Hydralazine and Minoxidil?

Fluid retention Signup and view all the answers

What is the mechanism of action of ACE inhibitors?

Blocks the binding of angiotensin II to smooth muscle receptors Signup and view all the answers

Which of the following is a contraindication for the use of spironolactone?

Hyperkalemia Signup and view all the answers

What is the primary effect of vasodilators on peripheral vascular resistance?

Decrease Signup and view all the answers

What is the usual dose for Captopril?

25 mg OD Signup and view all the answers

What is an example of a drug that is a direct renin inhibitor?

Aliskiren Signup and view all the answers

Which class of drugs are known to negate the effects of antihypertensives, except for aspirin?

Nonsteroidal anti-inflammatory drugs (NSAIDs) Signup and view all the answers

What is the primary therapeutic target in treating hypertension?

Controlling blood pressure Signup and view all the answers

What blood pressure measurements constitute hypertension according to ISH guidelines?

Systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg in the clinic Signup and view all the answers

What is the primary effect of effective pharmacological lowering of BP?

Prevents vessel damage and reduces morbidity and mortality Signup and view all the answers

What is the correlation between increase in office BP and cardiovascular events?

Increase in office BP correlates with incidence of cardiovascular events Signup and view all the answers

Which type of hypertension requires confirmation with repeated measurements and carries similar CV event risk as sustained hypertension?

Masked hypertension Signup and view all the answers

What serves as a warning sign for potential hypertension?

High-normal BP Signup and view all the answers

What is the primary therapeutic objective in treating hypertension?

Preventing vessel damage and reducing morbidity and mortality Signup and view all the answers

What is the primary reason for taking hypertension medication even if the patient does not feel any symptoms?

Hypertension is often asymptomatic until overt end damage is imminent Signup and view all the answers

Which system regulates intravascular fluid volume and can increase blood pressure?

Renin-angiotensin-aldosterone system Signup and view all the answers

What is the specific cause of hypertension in the majority of cases?

Essential hypertension due to multifactorial factors Signup and view all the answers

What is the primary effect of vasoconstriction on peripheral vascular resistance and blood pressure?

Increases peripheral vascular resistance and blood pressure Signup and view all the answers

Which guideline closely follows the European guideline compared to the American guideline?

ESC/ESH Signup and view all the answers

What is the primary risk factor for not prescribing drug treatment for hypertension?

Low total cardiovascular risk and no hypertension-mediated organ damage Signup and view all the answers

Which of the following drugs are vasoconstrictors and directly negate the effects of antihypertensives?

NSAIDs Signup and view all the answers

Which of the following is a major side effect of β-blockers?

Masking of hypoglycemia Signup and view all the answers

Which class of drugs act on the α-receptors in the brainstem to decrease blood pressure?

Centrally-acting α2 agonists Signup and view all the answers

Which type of drugs include α1-blockers, calcium channel blockers, and other vasodilators for severe hypertension?

Direct vasodilators Signup and view all the answers

What is the primary therapeutic target in treating hypertension?

Reducing peripheral vascular resistance Signup and view all the answers

Which of the following drugs is a direct renin inhibitor?

Aliskiren Signup and view all the answers

What type of hypertension is characterized by elevated blood pressure during doctor’s visits but not in other settings?

White coat hypertension Signup and view all the answers

What is the mechanism of action of calcium channel blockers?

Preventing the entry of calcium into smooth muscle cells Signup and view all the answers

What is the primary mechanism of action of ACE inhibitors and ARBs in treating hypertension?

Block the binding of angiotensin II to smooth muscle receptors, leading to arteriolar vasodilation Signup and view all the answers

Which of the following is a side effect specifically associated with direct vasodilators like Hydralazine and Minoxidil?

Fluid retention and lupus-like syndrome Signup and view all the answers

Which class of anti-hypertensive agents acts by directly dilating blood vessels?

Alpha-1 blockers Signup and view all the answers

What is the primary mechanism of action of calcium channel blockers (CCBs) like Amlodipine and Verapamil?

Block calcium channels in arteriolar smooth muscles, leading to arterial vasodilation Signup and view all the answers

Which factor affects blood pressure by increasing peripheral vascular resistance?

Increasing vasoconstriction Signup and view all the answers

What is the primary therapeutic target in treating hypertension?

Decreasing peripheral vascular resistance Signup and view all the answers

Which drug classification should not be combined in hypertension treatment due to compounded side effects?

Direct vasodilators and RAA inhibitors Signup and view all the answers

What constitutes hypertension according to ISH guidelines?

Systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg in the clinic Signup and view all the answers

What is the effect of vasoconstriction on peripheral vascular resistance and blood pressure?

Increases peripheral vascular resistance and blood pressure Signup and view all the answers

How often is diagnosis of hypertension typically confirmed?

2-3 office visits at 1-4 week intervals Signup and view all the answers

What is the correlation between high-normal BP and potential hypertension?

It serves as a warning sign for potential hypertension Signup and view all the answers

What is the primary cause of hypertension in most cases?

Essential hypertension due to multifactorial factors Signup and view all the answers

What blood pressure measurements constitute hypertension according to ISH guidelines?

Systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg Signup and view all the answers

How many office visits are typically required to confirm the diagnosis of hypertension?

2-3 visits at 1-4 week intervals Signup and view all the answers

Which class of drugs are sympathoplegic and decrease sympathetic influence on the heart by blocking $β$ receptors?

Beta blockers Signup and view all the answers

What is the risk associated with masked hypertension?

Higher risk of cardiovascular events Signup and view all the answers

What is the primary effect of effective pharmacological lowering of BP?

Prevents vessel damage and reduces morbidity Signup and view all the answers

What is the classification of hypertension based on?

Blood pressure measurement Signup and view all the answers

What is the primary reason for taking hypertension medication even if the patient does not feel any symptoms?

To prevent vessel damage and reduce morbidity Signup and view all the answers

What is the effect of vasoconstriction on peripheral vascular resistance and blood pressure?

Increases peripheral vascular resistance and blood pressure Signup and view all the answers

What does high-normal BP serve as?

A warning sign for potential hypertension Signup and view all the answers

What is the mechanism of action of ARBs (Angiotensin II Receptor Blockers)?

Block angiotensin II receptors Signup and view all the answers

Which type of drugs are vasoconstrictors and directly negate the effects of antihypertensives?

Alpha-1 blockers Signup and view all the answers

What is the correlation between increase in office BP and cardiovascular events?

Positive correlation Signup and view all the answers

Which of the following drugs is a direct vasodilator?

Hydralazine Signup and view all the answers

What is the primary mechanism of action of diuretics in treating hypertension?

Enhancement of sodium and water excretion Signup and view all the answers

Which of the following is a major side effect of angiotensin-converting enzyme (ACE) inhibitors?

Persistent dry cough Signup and view all the answers

What is the primary effect of sympathetic drugs in treating hypertension?

Decrease in heart rate Signup and view all the answers

Which of the following medications is a direct renin inhibitor?

Aliskiren Signup and view all the answers

What is the primary side effect associated with non-dihydropyridine calcium channel blockers?

Gynecomastia Signup and view all the answers

Which of the following is a side effect of hydralazine and minoxidil?

Hypertrichosis Signup and view all the answers

True or False: ACE inhibitors and ARBs are equally effective in reducing proteinuria compared to other antihypertensive agents.

False Signup and view all the answers

What is the primary mechanism of action of diuretics in treating hypertension?

Inhibiting the reabsorption of sodium and water in the nephron Signup and view all the answers

What is the primary effect of increasing venous return on blood pressure?

Leads to an increase in cardiac output and blood pressure Signup and view all the answers

Which of the following drug classes is considered a sympathoplegic agent for treating hypertension?

β-Blockers Signup and view all the answers

What is the role of the Renin-Angiotensin-Aldosterone System (RAAS) in regulating intravascular fluid volume?

It increases blood pressure by promoting vasoconstriction Signup and view all the answers

Which drug classification is known to directly negate the effects of antihypertensives, except for aspirin?

NSAIDs Signup and view all the answers

Which class of drugs acts by increasing venous return?

β-blockers Signup and view all the answers

Which drug is a centrally-acting $\alpha2$ agonist that acts on the $\alpha$-receptors in the brainstem to decrease blood pressure?

Clonidine Signup and view all the answers

Which drug classification includes both dihydropyridines and non-dihydropyridines that block calcium channels in arteriolar smooth muscles, leading to arterial vasodilation?

Calcium channel blockers Signup and view all the answers

What is the primary purpose of taking multiple office visits to confirm the diagnosis of hypertension?

To ensure accurate and consistent blood pressure measurements Signup and view all the answers

Which classification of hypertension is characterized by normal blood pressure in the clinic but elevated blood pressure at home?

Masked hypertension Signup and view all the answers

What is the primary therapeutic benefit of effective pharmacological lowering of blood pressure?

Prevention of vessel damage Signup and view all the answers

Which guideline closely aligns with the International Society of Hypertension (ISH) guidelines?

European Society of Cardiology/European Society of Hypertension (ESC/ESH) guidelines Signup and view all the answers

What is the primary reason for taking hypertension medication even if the patient does not feel any symptoms?

To prevent complications Signup and view all the answers

What is the primary therapeutic objective in treating hypertension?

To prevent target organ damage Signup and view all the answers

Which class of drugs are sympathoplegic and decrease sympathetic influence on the heart by blocking $β$ receptors?

Beta-blockers Signup and view all the answers

What constitutes hypertension according to the International Society of Hypertension (ISH) guidelines?

Systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg in the clinic Signup and view all the answers

How many office visits are typically required to confirm the diagnosis of hypertension?

2-3 office visits at 1-4 week intervals Signup and view all the answers

What is the primary cause of hypertension in most cases?

Essential hypertension due to multifactorial factors Signup and view all the answers

What is the risk associated with masked hypertension?

Higher risk of cardiovascular events compared to sustained hypertension Signup and view all the answers

What serves as a warning sign for potential hypertension?

High-normal BP Signup and view all the answers

What does effective pharmacological lowering of BP prevent?

Prevents vessel damage and reduces morbidity and mortality Signup and view all the answers

What is the correlation between increase in office BP and incidence of cardiovascular events?

Positive correlation Signup and view all the answers

Which system closely follows the European guideline compared to the American guideline?

European Society of Cardiology (ESC) Signup and view all the answers

What is the primary effect of high-normal BP?

Indication of potential hypertension Signup and view all the answers

What is the effect of high-normal BP on the incidence of cardiovascular events?

Increased risk of cardiovascular events Signup and view all the answers

What is the primary therapeutic target in treating hypertension?

Normalization of blood pressure Signup and view all the answers

What is the primary effect of effective pharmacological lowering of BP?

Prevents vessel damage and reduces morbidity and mortality Signup and view all the answers

Which of the following is a side effect specifically associated with direct vasodilators like Hydralazine and Minoxidil?

Fluid retention Signup and view all the answers

Which of the following is a contraindication for the use of spironolactone?

Pregnancy Signup and view all the answers

What is the primary mechanism of action of calcium channel blockers (CCBs) like Amlodipine and Verapamil?

Blocks calcium influx into cardiac and smooth muscle cells Signup and view all the answers

What is the classification of hypertension based on?

Underlying cause Signup and view all the answers

What is the primary reason for taking hypertension medication even if the patient does not feel any symptoms?

To reduce the risk of stroke Signup and view all the answers

What is the primary effect of effective pharmacological lowering of BP?

Decreased risk of stroke Signup and view all the answers

What is the primary therapeutic objective in treating hypertension?

Normalization of blood pressure Signup and view all the answers

What is the primary effect of vasodilators on peripheral vascular resistance?

Decrease Signup and view all the answers

What is the role of the Renin-Angiotensin-Aldosterone System (RAAS) in regulating intravascular fluid volume?

Promotes sodium and water retention Signup and view all the answers

What is a major side effect of centrally-acting α2 agonists like clonidine and methyldopa?

Bradycardia Signup and view all the answers

What is the specific cause of hypertension in the majority of cases?

Unknown (essential hypertension) Signup and view all the answers

What is the mechanism of action of ARBs (Angiotensin II Receptor Blockers)?

Block the binding of angiotensin II to smooth muscle receptors Signup and view all the answers

What is the primary role of the kidney in regulating intravascular fluid volume?

Releasing aldosterone Signup and view all the answers

Which factor affects blood pressure by increasing peripheral vascular resistance?

Vasoconstriction Signup and view all the answers

What is the primary therapeutic target in treating hypertension?

Decreasing peripheral vascular resistance Signup and view all the answers

What is the mechanism of action of ACE inhibitors?

Blocking the conversion of angiotensin I to angiotensin II Signup and view all the answers

What is the primary effect of vasoconstriction on peripheral vascular resistance and blood pressure?

Increases peripheral vascular resistance and blood pressure Signup and view all the answers

Which type of drugs are used as antihypertensive agents to decrease peripheral vascular resistance?

Direct vasodilators Signup and view all the answers

What is the classification of hypertension based on?

Office, ambulatory, and home blood pressure measurements Signup and view all the answers

What is the correlation between increase in office blood pressure and cardiovascular events?

Positive correlation Signup and view all the answers

What is the primary risk factor for not prescribing drug treatment if a patient's total cardiovascular risk is low?

Low intravascular fluid volume Signup and view all the answers

What is the primary reason for taking hypertension medication even if the patient does not feel any symptoms?

To prevent hypertension-mediated organ damage Signup and view all the answers

Which class of drugs are sympathoplegic and decrease sympathetic influence on the heart by blocking β receptors?

β-blockers Signup and view all the answers

What is the primary effect of increasing venous return on blood pressure?

Increases blood pressure Signup and view all the answers

Which of the following drugs can increase blood pressure and blunt the effect of antihypertensives?

Decongestants Signup and view all the answers

Which type of drugs are known to negate the effects of antihypertensives, except for aspirin?

NSAIDs Signup and view all the answers

Which of the following is a major side effect of β-blockers?

Rebound hypertension Signup and view all the answers

Which drug is a centrally-acting α2 agonist?

Clonidine Signup and view all the answers

Which class of drugs are sympathoplegic and decrease sympathetic influence on the heart by blocking $β$ receptors?

β-blockers Signup and view all the answers

What is the primary effect of centrally-acting α2 agonists like clonidine and methyldopa?

Sedation Signup and view all the answers

Which type of drugs include α1-blockers, calcium channel blockers, and other vasodilators for severe hypertension?

Direct vasodilators Signup and view all the answers

What is the mechanism of action of calcium channel blockers (CCBs) like Amlodipine and Verapamil?

Blocking calcium channels in arteriolar smooth muscles Signup and view all the answers

Which of the following drugs is a vasoconstrictor and directly negates the effects of antihypertensives?

NSAIDs Signup and view all the answers

What is the primary therapeutic target in treating hypertension?

Decreasing blood pressure Signup and view all the answers

Which of the following drugs is a sympathoplegic agent?

Clonidine Signup and view all the answers

What is the effect of vasoconstriction on peripheral vascular resistance and blood pressure?

Increases peripheral vascular resistance and blood pressure Signup and view all the answers

Study Notes

Diagnosis and Classification of Hypertension

Diagnosis of hypertension depends on blood pressure measurement, not patient-reported symptoms
Hypertension is often asymptomatic until overt end damage is imminent
International Society of Hypertension (ISH) guidelines state that systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg in the clinic constitutes hypertension
Diagnosis typically requires 2-3 office visits at 1-4 week intervals to confirm, but can be confirmed in a single visit if BP is very high and there is evidence of cardiovascular disease
Various sources, including JNC, ESC/ESH, ACC/AHA, and ISH, contribute to the classification of hypertension
Hypertension causes damage to blood vessels in the kidney, heart, and brain
Increase in office BP correlates with incidence of cardiovascular events and end-stage renal disease
Effective pharmacological lowering of BP prevents vessel damage and reduces morbidity and mortality
High-normal BP serves as a warning sign for potential hypertension
Masked hypertension, with normal BP in the clinic but elevated BP at home, requires confirmation with repeated measurements and carries similar CV event risk as sustained hypertension
International guidelines closely follow the European guideline compared to the American guideline
Specific causes of hypertension can only be established in 10-15% of patients, with most cases being essential hypertension due to multifactorial factors.

Hypertension Diagnosis and Treatment Summary

The ISH defines hypertension based on office, ambulatory, and home blood pressure measurements.
White Coat Hypertension is a condition where a patient has elevated blood pressure during doctor’s visits.
Hypertension diagnosis needs confirmation with repeated office and out-of-office blood pressure measurements.
Drug treatment may not be prescribed if a patient's total cardiovascular risk is low and there is no hypertension-mediated organ damage.
Factors that affect blood pressure include cardiac output (CO) and peripheral vascular resistance (PVR).
To treat hypertension, one can target factors affecting blood pressure, such as decreasing CO, PVR, and heart rate.
Vasoconstriction increases PVR and blood pressure, while vasodilation decreases PVR and blood pressure.
To treat hypertension, one can use vasodilators to decrease PVR.
Increasing venous return leads to an increase in CO and blood pressure, while decreasing venous return can decrease CO and blood pressure.
The kidney regulates intravascular fluid volume through the Renin-Angiotensin-Aldosterone System (RAAS), which can increase blood pressure.
Diuretics, sympathoplegic agents, direct vasodilators, and RAA inhibitors are used as antihypertensive agents with different mechanisms of action.
The different mechanisms of drug classifications permit the combination of drugs, but drugs with the same mechanisms of action should not be combined due to compounded side effects.

Diagnosis and Classification of Hypertension

Diagnosis of hypertension depends on blood pressure measurement, not patient-reported symptoms
Hypertension is often asymptomatic until overt end damage is imminent
International Society of Hypertension (ISH) guidelines state that systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg in the clinic constitutes hypertension
Diagnosis typically requires 2-3 office visits at 1-4 week intervals to confirm, but can be confirmed in a single visit if BP is very high and there is evidence of cardiovascular disease
Various sources, including JNC, ESC/ESH, ACC/AHA, and ISH, contribute to the classification of hypertension
Hypertension causes damage to blood vessels in the kidney, heart, and brain
Increase in office BP correlates with incidence of cardiovascular events and end-stage renal disease
Effective pharmacological lowering of BP prevents vessel damage and reduces morbidity and mortality
High-normal BP serves as a warning sign for potential hypertension
Masked hypertension, with normal BP in the clinic but elevated BP at home, requires confirmation with repeated measurements and carries similar CV event risk as sustained hypertension
International guidelines closely follow the European guideline compared to the American guideline
Specific causes of hypertension can only be established in 10-15% of patients, with most cases being essential hypertension due to multifactorial factors.

Diagnosis and Classification of Hypertension

Diagnosis of hypertension depends on blood pressure measurement, not patient-reported symptoms
Hypertension is often asymptomatic until overt end damage is imminent
International Society of Hypertension (ISH) guidelines state that systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg in the clinic constitutes hypertension
Diagnosis typically requires 2-3 office visits at 1-4 week intervals to confirm, but can be confirmed in a single visit if BP is very high and there is evidence of cardiovascular disease
Various sources, including JNC, ESC/ESH, ACC/AHA, and ISH, contribute to the classification of hypertension
Hypertension causes damage to blood vessels in the kidney, heart, and brain
Increase in office BP correlates with incidence of cardiovascular events and end-stage renal disease
Effective pharmacological lowering of BP prevents vessel damage and reduces morbidity and mortality
High-normal BP serves as a warning sign for potential hypertension
Masked hypertension, with normal BP in the clinic but elevated BP at home, requires confirmation with repeated measurements and carries similar CV event risk as sustained hypertension
International guidelines closely follow the European guideline compared to the American guideline
Specific causes of hypertension can only be established in 10-15% of patients, with most cases being essential hypertension due to multifactorial factors.

Antihypertensives and their interactions

Combining antihypertensives from different classes is recommended
NSAIDs (except aspirin) and decongestants can increase blood pressure and blunt the effect of antihypertensives
Decongestants are vasoconstrictors and directly negate the effects of antihypertensives
NSAIDs are known to negate the effects of antihypertensives, except for aspirin
β-blockers are sympathoplegic drugs, which include α-1-receptor blockers and centrally-acting α2 agonists
They decrease sympathetic influence on the heart by blocking β receptors
Major side effects of β-blockers include bradycardia, heart blocks, and masking of hypoglycemia
Terazosin is a centrally-acting α2 agonist
Centrally-acting α2 agonists like clonidine and methyldopa act on the α-receptors in the brainstem to decrease blood pressure
Side effects of centrally-acting α2 agonists include sedation, bradycardia, dry mouth, and rebound hypertension
Direct vasodilators include α1-blockers, calcium channel blockers, and other vasodilators for severe hypertension
Calcium channel blockers, both dihydropyridines and non-dihydropyridines, block calcium channels in arteriolar smooth muscles, leading to arterial vasodilation

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Test your knowledge of hypertension diagnosis and treatment with this quiz. Explore guidelines for diagnosing hypertension, understand the impact of blood pressure on cardiovascular health, and learn about pharmacological approaches to managing hypertension.