Hypertension Treatment Overview
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Questions and Answers

What percentage of Americans with hypertension are known to receive adequate treatment?

  • 20%
  • 74%
  • 85%
  • 48% (correct)

    • What is the main characteristic of primary hypertension?

  • It typically occurs only in children.
  • It has a definitive identifiable cause.
  • It is the most common form of hypertension. (correct)
  • It is often reversible with treatment.

    • Which of the following complications is NOT associated with untreated hypertension?

  • Stroke
  • Asthma (correct)
  • Heart disease
  • Kidney disease

    • What is a significant challenge in the management of hypertension?

    <p>Nonadherence to treatment</p> Signup and view all the answers

    What does the classification of hypertension include?

    <p>Both systolic and diastolic pressure values</p> Signup and view all the answers

    What is the primary strategy to slow progression of renal damage in nephrosclerosis?

    <p>Reduce blood pressure</p> Signup and view all the answers

    Which antihypertensive class is preferred in patients with diabetic nephropathy?

    <p>ACE inhibitors (ACEIs) and Angiotensin Receptor Blockers (ARBs)</p> Signup and view all the answers

    What should be the initial approach to treating hypertension in older adults?

    <p>Start with lower doses and increase slowly</p> Signup and view all the answers

    Why should ACE inhibitors be avoided in young women who are sexually active or pregnant?

    <p>They can cause fetal harm</p> Signup and view all the answers

    What is a common reason for the higher incidence of hypertension in African Americans compared to Caucasians?

    <p>Higher rates of untreated hypertension</p> Signup and view all the answers

    What is primary hypertension characterized by?

    <p>A chronic, progressive disorder that leads to a continuous rise in blood pressure.</p> Signup and view all the answers

    Which demographic is at the highest risk for developing primary hypertension?

    <p>Postmenopausal women.</p> Signup and view all the answers

    What is the primary distinction of secondary hypertension compared to primary hypertension?

    <p>It can potentially be cured by treating the underlying cause.</p> Signup and view all the answers

    What blood pressure readings confirm a diagnosis of hypertension in adults?

    <p>SBP greater than 130 mm Hg or DBP greater than 80 mm Hg.</p> Signup and view all the answers

    Which of the following is not identified as a major cardiovascular risk factor in hypertension evaluation?

    <p>Genetic testing for hypertension.</p> Signup and view all the answers

    What is one of the ultimate treatment goals for managing hypertension?

    <p>To maintain SBP below 130 mm Hg and DBP below 80 mm Hg.</p> Signup and view all the answers

    What is the first step in managing hypertension according to the treatment algorithm?

    <p>Implement lifestyle changes</p> Signup and view all the answers

    Which class of drugs is primarily recommended for initial therapy in patients without compelling indications?

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

    What should be considered before adding another antihypertensive drug?

    <p>Presence of secondary hypertension</p> Signup and view all the answers

    What is the rationale behind using drugs from different classes in hypertension therapy?

    <p>It provides greater targeting for blood pressure control</p> Signup and view all the answers

    What can be a consequence of using high doses of antihypertensive drugs initially?

    <p>Higher risk of adverse effects</p> Signup and view all the answers

    When can a step-down therapy be considered in hypertension management?

    <p>After blood pressure has been controlled for at least one year</p> Signup and view all the answers

    Which antihypertensive drug class is discouraged as first-line therapy due to its association with adverse cardiovascular events?

    <p>α1 blockers</p> Signup and view all the answers

    What is a significant benefit of using multiple drugs in hypertension therapy?

    <p>Lower dosages can be used for each agent</p> Signup and view all the answers

    Which of the following is NOT a recommended initial drug for patients with hypertension without compelling indications?

    <p>Direct-acting vasodilators</p> Signup and view all the answers

    What significant change occurs in baroreceptors when blood pressure is reduced slowly?

    <p>Gradual resetting to the new lower pressure</p> Signup and view all the answers

    What is the primary mechanism by which antihypertensive drugs lower blood pressure?

    <p>Decreasing peripheral resistance</p> Signup and view all the answers

    Which of the following drug classes can block reflex tachycardia to aid in reducing blood pressure?

    <p>β-Blockers</p> Signup and view all the answers

    How does the renin-angiotensin-aldosterone system (RAAS) contribute to increased blood pressure?

    <p>By causing systemic vasoconstriction</p> Signup and view all the answers

    What role do baroreceptors play in blood pressure regulation?

    <p>They transmit blood pressure information to the brain for regulation.</p> Signup and view all the answers

    Which antihypertensive drug class primarily acts by reducing blood volume?

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

    What is a consequence of the baroreceptor reflex when using antihypertensive medications?

    <p>Reflex tachycardia</p> Signup and view all the answers

    Which method is NOT an effective strategy to counteract the RAAS while using antihypertensive drugs?

    <p>Administering calcium channel blockers</p> Signup and view all the answers

    What happens to baroreceptors after prolonged antihypertensive treatment?

    <p>They begin to lower the threshold for normal pressure.</p> Signup and view all the answers

    What is one major mechanism through which antihypertensive drugs lower blood pressure?

    <p>Decreasing blood volume</p> Signup and view all the answers

    What primarily contributes to the reduction of blood pressure when antihypertensive drugs act in the brain stem?

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

    Which site of action for antihypertensive drugs promotes dilation of arterioles and veins?

    <p>Sympathetic ganglia</p> Signup and view all the answers

    What effect does the blockade of β1-adrenergic receptors on the heart have?

    <p>Decreased heart rate</p> Signup and view all the answers

    Which antihypertensive drug works by promoting salt and water excretion in the renal tubules?

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

    Which class of drugs is NOT typically used to suppress the sympathetic nervous system's influence on the heart and blood vessels?

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

    Which mechanism does NOT directly contribute to the actions of drugs targeting the renin-angiotensin-aldosterone system?

    <p>Decreased heart rate</p> Signup and view all the answers

    Which of the following is a consequence of blocking aldosterone receptors in the kidney?

    <p>Decrease in blood volume</p> Signup and view all the answers

    Ganglionic blocking agents have a significant reduction in blood pressure but are rarely used due to what reason?

    <p>Their use is limited to hypertensive emergencies.</p> Signup and view all the answers

    Inhibitors of angiotensin-converting enzyme (ACE) primarily lead to what physiological effect?

    <p>Decreased formation of angiotensin II</p> Signup and view all the answers

    What is the primary reason for the lifelong need for treatment in patients with hypertension?

    <p>Hypertension can lead to irreversible damage if untreated.</p> Signup and view all the answers

    Which type of hypertension accounts for the majority of cases?

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

    What class of patients is least likely to receive adequate treatment for hypertension?

    <p>Young adults without comorbidities</p> Signup and view all the answers

    What is one significant consequence of untreated chronic hypertension?

    <p>Development of heart disease</p> Signup and view all the answers

    What distinguishes primary hypertension from secondary hypertension?

    <p>Primary hypertension has no identifiable cause.</p> Signup and view all the answers

    What factors influence cardiac output, which in turn affects blood pressure?

    <p>Myocardial contractility and venous return</p> Signup and view all the answers

    How does the baroreceptor reflex primarily oppose antihypertensive treatment?

    <p>By promoting blood vessel constriction</p> Signup and view all the answers

    Which of the following drugs directly inhibits renin release?

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

    What is the result of activating the renin-angiotensin-aldosterone system (RAAS)?

    <p>Increased peripheral resistance</p> Signup and view all the answers

    How can long-term therapy influence the sensitivity of baroreceptors to blood pressure changes?

    <p>They reset to a lower level after extended treatment.</p> Signup and view all the answers

    What type of drug acts by promoting arteriolar dilation to control blood pressure?

    <p>Calcium Channel Blockers</p> Signup and view all the answers

    What is one way the sympathetic nervous system helps regulate blood pressure?

    <p>By activating β1 receptors to increase heart rate</p> Signup and view all the answers

    Which mechanism counteracts the blood pressure-lowering effects of antihypertensive medications through renal action?

    <p>Reduced glomerular filtration rate</p> Signup and view all the answers

    What is a characteristic feature of primary hypertension?

    <p>It leads to a gradual increase in blood pressure without identifiable causes.</p> Signup and view all the answers

    What increases the risk factor for primary hypertension among different demographic groups?

    <p>Age and ethnicity, with older adults and African Americans at higher risk.</p> Signup and view all the answers

    What diagnostic method is most accurately recommended for confirming hypertension?

    <p>Ambulatory blood pressure monitoring (ABPM).</p> Signup and view all the answers

    Which lifestyle modification is strongly encouraged for all patients with chronic hypertension?

    <p>Engagement in aerobic exercise.</p> Signup and view all the answers

    Which factor is NOT considered a major cardiovascular risk factor in patients with hypertension?

    <p>Adequate physical exercise.</p> Signup and view all the answers

    What is the ultimate treatment goal in managing hypertension?

    <p>To achieve a blood pressure below $130/80 ext{ mm Hg}$ while maintaining quality of life.</p> Signup and view all the answers

    What condition can arise from untreated hypertension in African Americans?

    <p>Decreased kidney function</p> Signup and view all the answers

    Which class of antihypertensive agents is least effective in African Americans without the presence of other conditions?

    <p>β blockers</p> Signup and view all the answers

    What should be the first line of action for treating hypertension in older adults?

    <p>Start with lower doses of medications</p> Signup and view all the answers

    Which diuretic is preferred in patients with advanced renal insufficiency?

    <p>Loop diuretics</p> Signup and view all the answers

    Which adverse effect is associated with antihypertensive drug therapy?

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

    What is the primary effect of antihypertensive drugs acting at the sympathetic ganglia?

    <p>Dilation of arterioles and veins</p> Signup and view all the answers

    How do diuretics contribute to lowering blood pressure?

    <p>By promoting salt and water excretion</p> Signup and view all the answers

    What effect does blockade of β1-adrenergic receptors on juxtaglomerular cells have?

    <p>Decreased production of angiotensin II</p> Signup and view all the answers

    Which class of antihypertensive drugs acts directly on vascular smooth muscle?

    <p>Calcium channel blockers</p> Signup and view all the answers

    What is the primary action of drugs that inhibit renin?

    <p>Decreased conversion of angiotensinogen to angiotensin I</p> Signup and view all the answers

    What mechanism primarily contributes to reduced blood pressure when antihypertensive drugs act on the brain stem?

    <p>Inhibition of vasoconstriction</p> Signup and view all the answers

    What happens to blood pressure with vasodilation of arterioles?

    <p>Decreases due to reduced vascular resistance</p> Signup and view all the answers

    Which site of action for antihypertensive drugs does NOT primarily promote dilation of blood vessels?

    <p>Renal tubules</p> Signup and view all the answers

    How does the blockade of aldosterone receptors in the kidneys affect blood pressure?

    <p>Promotes sodium and water excretion</p> Signup and view all the answers

    What role do ACE inhibitors play in blood pressure management?

    <p>Decrease production of angiotensin II</p> Signup and view all the answers

    What is the initial drug recommended for most patients without compelling indications for hypertension treatment?

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

    Which reason should be assessed before considering an additional antihypertensive medication?

    <p>Poor adherence to the initial drug</p> Signup and view all the answers

    What is a potential benefit of using multiple antihypertensive medications?

    <p>Targeting blood pressure control at several sites</p> Signup and view all the answers

    What is the effect on baroreceptors when blood pressure is gradually reduced?

    <p>They reset to a new lower pressure</p> Signup and view all the answers

    Which of the following combinations is appropriate for hypertension treatment?

    <p>A β blocker and a vasodilator</p> Signup and view all the answers

    What should be done if step-down therapy is unsuccessful after one year of controlled blood pressure?

    <p>Reassess lifestyle changes and medication regimen</p> Signup and view all the answers

    What is the rationale for using a lower initial dosage of antihypertensive drugs?

    <p>To minimize the risk of adverse effects</p> Signup and view all the answers

    In patients with compelling indications for hypertension treatment, which drug class is typically recommended?

    <p>ACE inhibitors</p> Signup and view all the answers

    How should dosage adjustments be made over time when managing hypertension?

    <p>Gradually increase or decrease, based on need</p> Signup and view all the answers

    What is a significant consequence of using α1 blockers in initial therapy for hypertension?

    <p>Increased levels of reflex tachycardia</p> Signup and view all the answers

    What is the primary reason hypertension requires lifelong treatment?

    <p>It is a chronic condition that cannot be cured.</p> Signup and view all the answers

    Which of the following complications is a direct risk of untreated hypertension?

    <p>Kidney disease</p> Signup and view all the answers

    What percentage of adults with hypertension do not take sufficient medication to control their blood pressure?

    <p>48%</p> Signup and view all the answers

    Which statement best describes primary hypertension?

    <p>It is the most common form with no identifiable cause.</p> Signup and view all the answers

    What is the primary characteristic of secondary hypertension?

    <p>It has an identifiable underlying cause.</p> Signup and view all the answers

    Which group has the highest risk of developing primary hypertension?

    <p>Postmenopausal women</p> Signup and view all the answers

    What is the main goal of treating hypertension?

    <p>Reduce cardiovascular and renal morbidity and mortality</p> Signup and view all the answers

    What diagnostic method is preferred to confirm hypertension?

    <p>Ambulatory blood pressure monitoring</p> Signup and view all the answers

    In patients with hypertension, what underlying condition could potentially allow for a cure?

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

    Which diagnostic test is NOT typically required for evaluating hypertension?

    <p>Chest X-ray</p> Signup and view all the answers

    What lifestyle modification is recommended to help manage hypertension?

    <p>Following the DASH eating plan</p> Signup and view all the answers

    What measure is most effective in slowing the progression of renal damage in nephrosclerosis?

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

    Which antihypertensive agents are considered most effective in patients with diabetes and nephropathy?

    <p>ACE inhibitors and ARBs</p> Signup and view all the answers

    In African American patients, which class of antihypertensive drugs is generally first-line treatment?

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

    What is an important consideration when prescribing antihypertensive medications to older adults?

    <p>Monitor for orthostatic hypotension due to blunted cardiovascular reflexes</p> Signup and view all the answers

    Why should potassium-sparing diuretics generally be avoided in patients with renal insufficiency?

    <p>They increase the risk of hyperkalemia</p> Signup and view all the answers

    What is the primary function of the baroreceptor reflex in blood pressure regulation?

    <p>To maintain blood pressure at a preset level</p> Signup and view all the answers

    Which of the following drug classes can effectively reduce blood volume to lower blood pressure?

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

    How does the renin-angiotensin-aldosterone system (RAAS) primarily elevate blood pressure?

    <p>By promoting vasoconstriction and fluid retention</p> Signup and view all the answers

    What mechanism allows α1 receptor activation to increase blood pressure?

    <p>Arteriolar constriction</p> Signup and view all the answers

    Which antihypertensive drug class is least likely to directly counteract the effects of the sympathetic nervous system?

    <p>Direct renin inhibitors</p> Signup and view all the answers

    What happens to the baroreceptors when blood pressure is lowered over a prolonged period?

    <p>They become less sensitive to changes in blood pressure</p> Signup and view all the answers

    Which adverse effect may occur as a result of excessive sympathetic stimulation during antihypertensive therapy?

    <p>Increased peripheral resistance</p> Signup and view all the answers

    Which class of drugs would directly inhibit the conversion of angiotensin I to angiotensin II?

    <p>ACE inhibitors</p> Signup and view all the answers

    What is a primary mechanism through which antihypertensive drugs that act on the brain stem lower blood pressure?

    <p>Decreased sympathetic outflow</p> Signup and view all the answers

    Which site of action for antihypertensive drugs primarily involves the blockade of β1-adrenergic receptors?

    <p>Cardiac tissue</p> Signup and view all the answers

    What is the primary effect of blockade of α1-adrenergic receptors on blood vessels?

    <p>Dilation of arterioles and veins</p> Signup and view all the answers

    Which class of antihypertensive drugs acts by promoting excretion of sodium and water in the renal tubules?

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

    Inhibition of which component of the renin-angiotensin-aldosterone system (RAAS) has a direct effect on peripheral vasodilation?

    <p>Angiotensin II</p> Signup and view all the answers

    What is the initial recommended drug for most patients with hypertension who do not have compelling indications?

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

    What effect do sympatholytic drugs have on heart activity during antihypertensive treatment?

    <p>Reduce myocardial contractility</p> Signup and view all the answers

    Why is it inappropriate to combine two β blockers in antihypertensive therapy?

    <p>They have the same mechanism of action.</p> Signup and view all the answers

    What is a significant role of diuretics in antihypertensive therapy?

    <p>Enhance effects of other hypotensive drugs</p> Signup and view all the answers

    What is the primary benefit of starting antihypertensive medication at low dosages?

    <p>To minimize adverse effects.</p> Signup and view all the answers

    Which mechanism of action is NOT associated with calcium channel blockers (CCBs)?

    <p>Suppress sympathetic outflow</p> Signup and view all the answers

    What is a limitation of ganglionic blocking agents in hypertension treatment?

    <p>They produce profound reduction in blood pressure</p> Signup and view all the answers

    What happens to baroreceptors when blood pressure is reduced slowly over time?

    <p>They rapidly reset to the new lower pressure.</p> Signup and view all the answers

    What is a key effect of antihypertensive drugs targeting the renal tubules?

    <p>Reduction of blood volume</p> Signup and view all the answers

    What is a critical step after controlling blood pressure for at least one year in hypertensive patients?

    <p>Attempt step-down therapy.</p> Signup and view all the answers

    What is an example of a compelling indication for choosing specific antihypertensive drugs?

    <p>Presence of diabetes.</p> Signup and view all the answers

    What should be assessed before considering the addition of another antihypertensive drug?

    <p>Previous drug adherence.</p> Signup and view all the answers

    Why are centrally acting sympatholytics and direct-acting vasodilators not used as first-line treatments?

    <p>They have a high incidence of adverse effects.</p> Signup and view all the answers

    What is an important practice when combining antihypertensive medications?

    <p>Each drug should have a different mechanism of action.</p> Signup and view all the answers

    What type of medication is not typically recommended for initial therapy in patients with hypertension?

    <p>Centrally acting sympatholytics</p> Signup and view all the answers

    Study Notes

    Hypertension: Treatment Overview

    • Hypertension, or high blood pressure, is a prevalent, chronic condition affecting millions globally (over 1 billion), a leading cause of mortality, and has seen a nearly 20% increase in the past two decades.
    • Untreated hypertension leads to severe complications like heart disease, kidney disease, and stroke.
    • While treatment can mitigate symptoms and long-term issues, a cure is not possible; therefore, lifelong management is crucial.
    • Treatment nonadherence is a significant concern, with undertreatment prevalent in affected populations, as evidenced by only 74% of Americans with the disease undergoing treatment and only 48% taking sufficient medicine to control blood pressure. Nearly 2 million American children, 85 million American adults and more than 1 billion people worldwide are affected.

    Types of Hypertension

    • Primary (Essential) Hypertension: The most common type, with no identifiable cause. Diagnosis is based on ruling out other causes. It’s a chronic, progressive condition leading to a continuous, gradual increase in blood pressure over time. Affects about 30% of US adults. Risk factors include age (older are more at risk), race (African Americans more than Caucasians), and gender (postmenopausal women more than premenopausal women).
    • Secondary Hypertension: Elevated blood pressure resulting from a known underlying cause (e.g., Cushing syndrome, pheochromocytoma, oral contraceptives). Treating the underlying cause can lead to a cure. Secondary hypertension is less common, affecting less than 10% of hypertensive patients.

    Basic Considerations in Hypertension Diagnosis

    • Diagnosis: Based on multiple readings, not just one initial measurement. Repeat blood pressure measurements are needed over several office visits, with two measurements at least 5 minutes apart, in a seated position with feet on the floor, checking both arms. Ideally, ambulatory blood pressure monitoring (ABPM) is used to confirm diagnosis because office readings are often higher leading to inaccurate, false-positive results.
    • Ambulatory Blood Pressure Monitoring (ABPM): Preferred for accurate diagnosis due to unreliability of office-based readings; they sometimes produce false positives, leading to unnecessary treatment. Experts recommend using ABPM for diagnosis.

    Patient Evaluation

    • Objective: Assess potential causes of hypertension and factors increasing cardiovascular risk.
      • Evaluate for treatable underlying causes: Cushing syndrome, pheochromocytoma, oral contraceptive use.
      • Assess for factors increasing cardiovascular risk, requiring aggressive therapy: Existing target-organ damage (heart disease, left ventricular hypertrophy, angina, prior MI, coronary revascularization, heart failure, stroke, chronic kidney disease, peripheral arterial disease, retinopathy), major cardiovascular risk factors (cigarette smoking, physical inactivity, dyslipidemia, diabetes, microalbuminuria, age >55 (men), >65 (women), family history of premature cardiovascular disease).
    • Diagnostic Tests: Electrocardiogram (ECG), complete urinalysis, hemoglobin/hematocrit, and blood levels of sodium, potassium, calcium, creatinine, glucose, uric acid, triglycerides, and cholesterol (total, LDL, HDL).

    Treatment Goals

    • Overall Goal: Reduce cardiovascular and renal morbidity and mortality without negatively affecting quality of life.
    • Target BP Values (Adults): SBP < 130 mmHg and DBP < 80 mmHg.

    Therapeutic Interventions: Hypertension Management

    • Lifestyle Modifications: Crucial for all patients, impacting blood pressure and other cardiovascular risks; include sodium restriction, DASH diet, alcohol moderation, aerobic exercise, healthy weight, and smoking cessation.
    • Drug Therapy: Used alongside lifestyle modifications for effective blood pressure control. Collaboration between prescriber and patient, using various drug classes.

    Classes of Antihypertensive Drugs

    • Detailed information about Classes of Antihypertensive Drugs (Diuretics, Sympatholytics, CCBs, RAAS Suppressants) remains the same (as provided in the original notes).

    Treatment Algorithm

    • Initial Steps: Lifestyle modifications first, followed by drug therapy if needed. Single-drug initiation is common.
    • Drug Selection Considerations: Evaluate compelling indications influencing initial drug selection; add drugs if needed, but consider patient response and minimal side effects. Combination therapy is important for effective and safe lower dosage treatments, targeting BP control from multiple sites.
    • Initial Drug Choice for Patients without Compelling Indication: Thiazide diuretics are currently recommended, based on long-term trials of effectiveness, tolerance, and affordability.
    • Patients with Compelling Indications: Specific drugs indicated for heart failure or diabetes (as indicated in Table 41.3).

    Individualizing Therapy

    • Details about Individualizing Therapy (Renal Disease, Diabetes) remain the same (as provided in the original notes). Specific dosage adjustment needed.

    Minimizing Adverse Effects

    • Tailoring Regimens: Adjust drug selection and dosages based on individual patient response and sensitivity, identified side effects.
    • Collaborative Approach: Create a treatment plan involving the patient and prescriber; address specific concerns and potential issues / triggers.
    • Monitoring for Adverse Effects: Close monitoring and reporting of any side effects.
    • Low Initial Doses: Begin with low doses and gradually increase. Minimizes risk of abrupt/severe BP lowering.

    Promoting Adherence Treatment

    • Patient Education: Explain hypertension as a serious condition and the importance of adherence; explain the nature of the asymptomatic condition; stress long-term commitment.
    • Minimizing Side Effects: Choose appropriate, well-tolerated medications.
    • Collaborative Relationships: Emphasize the partnership.
    • Simplified Regimens: Prioritize once or twice daily dosing.
    • Important Considerations: Address chronic asymptomatic nature and the sustained, lifelong commitment to treatment.

    Hypertension in Pregnancy

    • Chronic Hypertension: Hypertension pre-existing or detected before 20 weeks; continue existing anti-hypertensive drugs, except ACEIs, ARBs, and DRIs (due to potential fetal harm).
    • Preeclampsia: Develops after week 20, potentially serious; treatment depends on severity and fetal maturity; delivery is often the cure.
    • Differentiation: Understand the distinction between chronic hypertension and preeclampsia in prenatal care; different treatments are used.
    • Severe Hypertension: SBP >160 mm Hg or DBP >110 mm Hg requires treatment.
    • Mild Hypertension: SBP 140 to 159 mm Hg or DBP 90 to 109 mm Hg generally does not require treatment.

    Special Populations

    • African Americans: Often more severe, higher-risk hypertension; diuretics often first-choice treatment, but other drugs might prove more effective, depending.
    • Children and Adolescents: Secondary hypertension is more common; treatment is similar to adults, with careful dose adjustment and avoidance of ACEIs, ARBs during pregnancy.
    • Older Adults: Isolated systolic hypertension is typical; orthostatic hypotension is a risk; initial lower doses; slower dosage escalation.

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    Description

    This quiz provides an overview of hypertension, including its prevalence, complications, and the importance of lifelong management. It also covers the two main types of hypertension: primary and secondary. Understand the difference between essential hypertension and the more treatable secondary causes.

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