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Questions and Answers
A 65-year-old patient with hypertension and diabetes mellitus has a blood pressure reading of 145/92 mmHg. According to the 2020 Philippine guidelines, what is the initial blood pressure target for this patient to reduce cardiovascular risk?
A 65-year-old patient with hypertension and diabetes mellitus has a blood pressure reading of 145/92 mmHg. According to the 2020 Philippine guidelines, what is the initial blood pressure target for this patient to reduce cardiovascular risk?
- Less than 130/80 mmHg
- Less than 150/90 mmHg
- Less than 140/90 mmHg (correct)
- Less than 120/70 mmHg
An 82-year-old patient has a blood pressure of 155/95 mmHg. According to the 2020 Philippine guidelines, what is the recommended initial blood pressure target for this patient?
An 82-year-old patient has a blood pressure of 155/95 mmHg. According to the 2020 Philippine guidelines, what is the recommended initial blood pressure target for this patient?
- Less than 130/80 mmHg
- Less than 150/90 mmHg
- Less than 140/90 mmHg (correct)
- Less than 160/100 mmHg
A 58-year-old patient with chronic kidney disease (CKD III) has a blood pressure of 142/91 mmHg. What is the recommended blood pressure target for this patient, according to the 2020 Philippine hypertension guidelines?
A 58-year-old patient with chronic kidney disease (CKD III) has a blood pressure of 142/91 mmHg. What is the recommended blood pressure target for this patient, according to the 2020 Philippine hypertension guidelines?
- Less than 130/80 mmHg (correct)
- Less than 140/90 mmHg
- Less than 120/80 mmHg
- Less than 150/90 mmHg
According to the 2020 Philippine guidelines, which of the following is NOT typically considered a preferred first-line agent for managing hypertension in the general adult population?
According to the 2020 Philippine guidelines, which of the following is NOT typically considered a preferred first-line agent for managing hypertension in the general adult population?
A 70-year-old patient with hypertension is also diagnosed with low-risk cardiovascular disease and stage IV chronic kidney disease. What blood pressure target is recommended for this patient according to the 2020 Philippine guidelines?
A 70-year-old patient with hypertension is also diagnosed with low-risk cardiovascular disease and stage IV chronic kidney disease. What blood pressure target is recommended for this patient according to the 2020 Philippine guidelines?
A 60-year-old patient with diabetes and hypertension has a blood pressure consistently above 140/90 mmHg despite lifestyle modifications. According to the 2020 Philippine guidelines, what is the recommended initial pharmacological approach?
A 60-year-old patient with diabetes and hypertension has a blood pressure consistently above 140/90 mmHg despite lifestyle modifications. According to the 2020 Philippine guidelines, what is the recommended initial pharmacological approach?
According to the 2020 Philippine guidelines, for which of the following conditions is a blood pressure target of less than 130/80 mmHg recommended to reduce the risk of nephropathy?
According to the 2020 Philippine guidelines, for which of the following conditions is a blood pressure target of less than 130/80 mmHg recommended to reduce the risk of nephropathy?
A 75-year-old patient with hypertension is being considered for pharmacotherapy. Their blood pressure consistently reads 148/88 mmHg. According to the 2020 Philippine guidelines, is pharmacotherapy indicated and why?
A 75-year-old patient with hypertension is being considered for pharmacotherapy. Their blood pressure consistently reads 148/88 mmHg. According to the 2020 Philippine guidelines, is pharmacotherapy indicated and why?
For a non-dialysis Chronic Kidney Disease (CKD) patient with albuminuria (urinary albumin to creatinine ratio >= 30 mg/g), which of the following is the most appropriate initial treatment, according to the guideline?
For a non-dialysis Chronic Kidney Disease (CKD) patient with albuminuria (urinary albumin to creatinine ratio >= 30 mg/g), which of the following is the most appropriate initial treatment, according to the guideline?
In the management of acute ischemic stroke, when a patient is eligible for IV thrombolysis but not for mechanical thrombectomy, what is the recommended blood pressure target prior to thrombolysis?
In the management of acute ischemic stroke, when a patient is eligible for IV thrombolysis but not for mechanical thrombectomy, what is the recommended blood pressure target prior to thrombolysis?
A patient with acute ischemic stroke is not eligible for IV thrombolysis or mechanical thrombectomy and presents with severe hypertension (SBP > 220 mmHg, DBP > 120 mmHg). According to guideline recommendations, how should their blood pressure be managed in the first 24 hours?
A patient with acute ischemic stroke is not eligible for IV thrombolysis or mechanical thrombectomy and presents with severe hypertension (SBP > 220 mmHg, DBP > 120 mmHg). According to guideline recommendations, how should their blood pressure be managed in the first 24 hours?
In a patient presenting with intracranial hemorrhage and a SBP of 190 mmHg, what is the recommended initial blood pressure management strategy?
In a patient presenting with intracranial hemorrhage and a SBP of 190 mmHg, what is the recommended initial blood pressure management strategy?
According to the provided guidelines, what is the blood pressure threshold for initiating pharmacological treatment for secondary prevention of cardiovascular events?
According to the provided guidelines, what is the blood pressure threshold for initiating pharmacological treatment for secondary prevention of cardiovascular events?
According to guideline, what is the recommendation regarding lowering blood pressure acutely to less than 140 mmHg in patients with intracranial hemorrhage?
According to guideline, what is the recommendation regarding lowering blood pressure acutely to less than 140 mmHg in patients with intracranial hemorrhage?
A patient with resistant hypertension is already on a diuretic and ACE inhibitor. According to guideline, what additional medication should be considered?
A patient with resistant hypertension is already on a diuretic and ACE inhibitor. According to guideline, what additional medication should be considered?
A patient with Chronic Kidney Disease presents with hyperkalemia after beginning ACE inhibitor treatment. According to the guideline, what is the recommendation?
A patient with Chronic Kidney Disease presents with hyperkalemia after beginning ACE inhibitor treatment. According to the guideline, what is the recommendation?
A non-dialysis patient with urine excretion of 40mg protein per 24 hours, what is the blood pressure target acording to guideline?
A non-dialysis patient with urine excretion of 40mg protein per 24 hours, what is the blood pressure target acording to guideline?
A Chronic Kidney Disease (CKD) patient with albuminuria is prescribed an ACE inhibitor. After one month, their creatinine levels have increased by 35% over baseline. According to the guideline, what is the recommendation?
A Chronic Kidney Disease (CKD) patient with albuminuria is prescribed an ACE inhibitor. After one month, their creatinine levels have increased by 35% over baseline. According to the guideline, what is the recommendation?
Flashcards
Hypertension BP threshold (General)
Hypertension BP threshold (General)
140/90 mmHg is the threshold to start treatment in most adults.
Age-related BP target (General)
Age-related BP target (General)
For those 80 years and older, target is less than 150/90 mmHg.
Preferred agents for adults
Preferred agents for adults
First-line agents include ACE inhibitors, ARBs, calcium channel blockers, and thiazide diuretics.
Hypertension BP threshold (Diabetes)
Hypertension BP threshold (Diabetes)
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Diabetes BP target
Diabetes BP target
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Hypertension BP threshold (CKD)
Hypertension BP threshold (CKD)
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CKD BP target (Low CV risk)
CKD BP target (Low CV risk)
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CKD target (Stage III)
CKD target (Stage III)
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Thiazide Diuretics
Thiazide Diuretics
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ACD with albuminuria
ACD with albuminuria
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ACE inhibitor criteria
ACE inhibitor criteria
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Resistant Hypertension
Resistant Hypertension
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IV thrombolysis SBP threshold
IV thrombolysis SBP threshold
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Severe Hypertension in Stroke
Severe Hypertension in Stroke
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Intracranial Hemorrhage SBP goal
Intracranial Hemorrhage SBP goal
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Secondary Prevention BP
Secondary Prevention BP
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Nicardipine use
Nicardipine use
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Labetalol indication
Labetalol indication
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Study Notes
Hypertension Management Guidelines (Philippines 2020)
- General BP Threshold (Adults): 140/90 mmHg, 150/90 mmHg for those over 80 years old
- Diabetes Mellitus: Blood pressure targets equivalent to or greater than 140/90 mmHg.
- Chronic Kidney Disease: Blood pressure targets of 140/90 mmHg at minimum.
- Acute Ischemic Stroke: Blood pressure targets under 185/110 mmHg before thrombolysis and during infusion, and < 180/105 mmHg within 24 hours.
- Preferred Medications (General): ACE inhibitors, ARBs, Calcium Channel Blockers (CCBs), Thiazide diuretics.
- Acute Ischemic Stroke - Thrombolisis Ineligibility: If blood pressure is > 185/110 mmHg before thrombolysis and > 185/110 mmHg during infusion, and >/=180 mmHg for mechanical thrombectomy.
- Acute Ischemic Stroke - Thrombolysis Eligibility: Less than 185/110 mmHg prior to thrombolysis and during infusion.
- Intracranial Hemorrhage: If blood pressure is greater than or equal to 180 mmHg.
- Severe Hypertension: DBP (Diastolic Blood Pressure) > 120 mmHg.
- Chronic Kidney Disease (CKD) - Risk: CKD IV and V: 140/90 mmHg, CKD III: 130/80 mmHg, Non-dialysis patients: <120 mmHg, and urine excretion >30mg per 24 hours: 130/80 mmHg.
- Resistant Hypertension: May add Mineralocorticoid Receptor Antagonist to existing regimens.
Pregnancy
- Blood pressure target of 140/90 mmHg.
- Acute onset severe hypertension: If SBP is greater or equal to 160 mmHg or DBP is greater than or equal to 110 mmHg.
Pediatric Population
- Blood Pressure Targets: <13 years: BP ≥ 90th percentile for age, sex, and height, ≥13 years: BP ≥ 120/80 mmHg
- Severe Hypertension (Children): 95th percentile +12 mmHg or ≥140/90 mmHg (whichever is lower)
- Co-morbidities: Management may vary based on presence of diabetes or chronic kidney disease.
Management Algorithm (Adults)
- If high blood pressure, lifestyle changes should be advised as a first step.
- If blood pressure isn't controlled after three months of lifestyle changes, use a single drug from the initial drug list.
- If blood pressure still not controlled with monotherapy, add a second drug from the preferred combination or add another first-line drug choice
- BP must remain or get lowered to between 110 and 130 mmHg, based on the specific considerations for each individual.
Management Algorithm (Acute Stroke)
- If stroke is ischemic, consider IV Thrombolysis/Thrombectomy candidacy.
- If ischemic/Stroke and High BP > 185,110 mmHg: Candidates to IV thrombolysis.
- For patients with high blood pressure, BP must be kept stable, with careful lowering, to reduce variability.
- If stroke is hemorrhagic: If blood pressure is less than 180 mmHg, keep BP stable with careful attention. Maintaining a MAP between 110-130 is recommended.
- Maintain a blood pressure target of <180/105 mmHg within the next 24 hours.
Management Algorithm (Pediatric)
- If blood pressure is elevated, conduct further measurements, average.
- Recommend lifestyle modification as a first approach, and if BP remains elevated, use single-drug therapy (ACEi/ARB or CCB).
- If blood pressure remains high, consider combining drugs in patients with co-morbidities like CKD or diabetes; for example, ACEi/ARB + diuretic, or CCB + Diuretic.
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Description
Overview of the 2020 Philippine guidelines for managing hypertension in adults, including blood pressure thresholds for various conditions like diabetes, chronic kidney disease, and stroke. Covers preferred medication classes and specific blood pressure targets for acute ischemic stroke and intracranial hemorrhage.
