Diagnosis & Guidelines
A 48-year-old woman has two separate office BP readings of 132/84 mmHg. According to the 2017 ACC/AHA guidelines, his BP reading indicates:
Stage 1 hypertension
A 45-year-old patient starts a medication to manage her blood pressure and returns complaining of a persistent dry cough
ACE inhibitor side effect
A 40-year-old woman has headaches, palpitations, and episodic high blood pressure
Pheochromocytoma
The organ most commonly damaged by chronic high blood pressure
The heart
The DASH acronym stands for:
Dietary Approaches to Stop Hypertension
A 68-year-old woman presents with a BP of 190/112 mmHg but has no symptoms and a normal exam. This patient's diagnosis is:
Hypertensive urgency (markedly elevated BP without evidence of new or worsening target-organ damage)
A 45-year-old man with recurrent calcium oxalate kidney stones is found to have elevated blood pressure. His provider selects a medication that will both lower his BP and reduce stone formation.
Thiazide diuretic
A 55-year-old man with a history of atherosclerosis has new-onset hypertension and abdominal bruit
Renal artery stenosis
The condition that results from high blood pressure causing the heart muscle to thicken
Left ventricular hypertrophy
The recommended daily sodium intake for individuals with hypertension
Less than 2,300 mg
A 45-year-old woman with suspected white coat hypertension has elevated office readings but normal home BP logs. The next best step to confirm the diagnosis is:
Ambulatory blood pressure monitoring
A pregnant woman presents with chronic hypertension. Which medication is safest for blood pressure control?
Labetalol – first choice for many clinicians; alpha and beta-blocker
Nifedipine (extended-release) – dihydropyridine CCB
Methyldopa – historically first-line, less used due to side effects (orthostatic hypotension, dry mouth)
30-year-old woman with poorly controlled hypertension has irregular menstrual cycles. On PE, you note multiple hairs along her chin. The most likely diagnosis:
Polycystic ovary syndrome (PCOS)
Common eye findings commonly seen in hypertensive retinopathy
Cotton wool spots, AV nicking, flame hemorrhages
Two types of foods emphasized in the DASH diet
vegetables
fruits
whole grains
fat-free or low-fat dairy products
fish
poultry
beans
nuts
A 52-year-old man presents with a BP of 220/130 mmHg confusion and blurred vision. His is BP 220/130 mmHg. Fundoscopy reveals papilledema. The diagnosis is:
Hypertensive emergency
- SBP/DBP >180/110–120 mm Hg with evidence of new or worsening target-organ damage
- asymptomatic markedly elevated inpatient BP (SBP/DBP >180/110–120 mm Hg without evidence of new or worsening target-organ damage)
- Asymptomatic elevated inpatient BP SBP/DBP ≥130/80 mm Hg without evidence of new or worsening target-organ damage
A 65-year-old patient with hypertension and heart failure with reduced ejection fraction is being started on an antihypertensive. The two classes that offer mortality benefit include
ACE inhibitors (or ARBs if ACE inhibitors are not tolerated)
A 38-year-old man has resistant hypertension and low potassium. Labs show a high aldosterone-to-renin ratio
Primary hyperaldosteronism
This kidney disease is caused by long-standing hypertension, specifically characterized by arteriole thickening and glomerular scarring
Hypertensive nephrosclerosis
Long-term regular physical activity affects blood pressure by:
It lowers blood pressure
A 67-year-old woman with diabetes has BP readings of 144/88 mmHg on multiple visits. Her target BP goal according to current ACC/AHA guidelines is:
<130/80 mmHg
A 55-year-old man with resistant hypertension is started on pharmacotherapy. At follow-up, he reports breast tenderness, and labs show elevated potassium. The most likely medication was
Spironolactone
A 29-year-old man presents with sudden-onset severe hypertension, chest pain, diaphoresis, and dilated pupils. He is anxious, restless, and reports using “something to stay awake” at a party. The most likely "something" was
Your patient presents with an elevated blood pressure reading for the second visit to the office in a row and wishes to know what this puts her at risk for. Three serious disorders hypertension independently predisposes this patient for include:
Heart failure, CAD, stroke, renal disease, and peripheral artery disease
The recommended amount of moderate-intensity exercise per week for blood pressure management
At least 150 minutes