michigan hypertension core curriculum - State of Michigan

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Michigan Hypertension Core Curriculum 2010 Developed by the Hypertension Expert Group A Partnership of the National Kidney Foundation of Michigan and the Michigan Department of Community Health NKFM & MDCH 3
Page 1: MICHIGAN HYPERTENSION CORE CURRICUL
Page 5 and 6: Acknowledgements Hypertension Exper
Page 7 and 8: Produced April 2010 Permission is g
Page 9 and 10: Hypertension Management Controversi
Page 11 and 12: Measurement Methods Early detection
Page 13 and 14: the BP understands current national
Page 15 and 16: Table 1: Guidelines for Obtaining A
Page 17 and 18: References: 1. Chobanian AV, Bakris
Page 19 and 20: Essential (Primary) Hypertension: D
Page 21 and 22: Figure 2 Figure 3 NKFM & MDCH 21
Page 23 and 24: eadings were higher than150/96 mm H
Page 25 and 26: Figure 1. Arterial Waveform These r
Page 27 and 28: Figure 3. Hemodynamic Consequences
Page 29 and 30: 4. Cardiovascular-Renal Complicatio
Page 31 and 32: The higher the level of BP, the mor
Page 33 and 34: Figure 5. Chronic Kidney Disease Th
Page 35 and 36: Clinical Implications: In the setti
Page 37 and 38: Clinical Implications: The clinicia
Page 39 and 40: Special Populations Introduction to
Page 41 and 42: to elevated BP causes progressive g
Page 43 and 44: than other groups. Similarly, Wong
Page 45 and 46: Table 1 Prerenal Disease Obstructiv
Page 47 and 48: Figure 1: Causes of ESRD. USRDS 200
Page 49 and 50: 21. Onuigbo MA. RAAS blockade, rena
Page 51 and 52: individuals. 2, 5 The risk of AD in
Page 53 and 54:
Figures: Figure 1. Graph showing pr
Page 55 and 56:
Figure 1: Prevalence, Treatment and
Page 57 and 58:
same individual is associated with
Page 59 and 60:
In candidates with significant orth
Page 61 and 62:
Figure 2. CDC. National Diabetes Fa
Page 63 and 64:
mellitus: results of the HOPE study
Page 65 and 66:
syndrome may have additional qualit
Page 67 and 68:
Tables: 1. Criteria for metabolic s
Page 69 and 70:
Figure 2: References: Increased Ris
Page 71 and 72:
Special Populations: African-Americ
Page 73 and 74:
premature onset of HTN and the larg
Page 75 and 76:
in AA is poorly controlled. There a
Page 77 and 78:
2. Which of the following contribut
Page 79 and 80:
Table 5. Therapeutic Lifestyle Chan
Page 81 and 82:
22. Stolley MR, Fitzgibbon ML, Schi
Page 83 and 84:
Special Populations: Hispanics Sila
Page 85 and 86:
a. Genetic differences b. Adherence
Page 87 and 88:
Obstructive Sleep Apnea Susan Steig
Page 89 and 90:
The prevalence of OSA in hypertensi
Page 91 and 92:
Table 1 Differential diagnosis of p
Page 93 and 94:
Measurement of plasma free metaneph
Page 95 and 96:
References: 1. Unger N, Deutschbein
Page 97 and 98:
PCOS, independent of BMI that decre
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Clinical Features: This is usually
Page 101 and 102:
and assays is key to interpretation
Page 103 and 104:
CVA (especially hemmorhagic) prior
Page 105 and 106:
control BP in addition to aldostero
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EPIDEMIOLOGY OF RAS Fibromuscular d
Page 109 and 110:
the clinical history and patient ch
Page 111 and 112:
esponse to revascularization. 42 In
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trial, angioplasty resulted in sign
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without ARAS, 109 and mortality rat
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generally have renovascular hyperte
Page 119 and 120:
Despite publication of the 2005 ACC
Page 121 and 122:
Medical therapies, particularly ant
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normal, but total GFR and stenotic
Page 125 and 126:
Table 2. ACC/AHA guidelines for ren
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4. Recommendations for pharmacologi
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Table 5. Clinical evaluation of ren
Page 131 and 132:
Table 8. Causes of failure of renal
Page 133 and 134:
Table 10. Classification of RAS, re
Page 135 and 136:
Ischemic nephropathy: Renal parench
Page 137 and 138:
286. 20. White CJ. Catheter-based t
Page 139 and 140:
59. Collins R, Peto R, MacMahon S,
Page 141 and 142:
99. Steinbach F, Novick AC, Campbel
Page 143 and 144:
d. All of the above e. None of the
Page 145 and 146:
of hypertension. 19 Furthermore, th
Page 147 and 148:
pregnant women with hypertension an
Page 149 and 150:
Pervasive Hypertension Myths Hypert
Page 151 and 152:
4. Weir MR, Flack JM, Applegate WB.
Page 153 and 154:
Race Percent 20.0 17.5 15.0 12.5 10
Page 155 and 156:
References: 1. Nasser SA, Lai Z, O
Page 157 and 158:
Initial Evaluation Initial Evaluati
Page 159 and 160:
The kidney is both a target as well
Page 161 and 162:
Premature stroke and/or family hist
Page 163 and 164:
Thyroid disease Thyroid disease is
Page 165 and 166:
E Circulation G Neurologic General
Page 167 and 168:
contraction into a stiff, non-compl
Page 169 and 170:
12. Anderson KM, Wilson PW, Odell P
Page 171 and 172:
Introduction While the bulk of clin
Page 173 and 174:
High potassium intake High magnesi
Page 175 and 176:
more than 4 drinks a day had 3 to 7
Page 177 and 178:
2. After how many minutes of weekly
Page 179 and 180:
Goals for Treatment of Hypertension
Page 181 and 182:
Key Points: 1.) The recommended JNC
Page 183 and 184:
RAS antagonists slow CKD progressio
Page 185 and 186:
Diuretics Overview of Major Anti-Hy
Page 187 and 188:
antihypertensive agents in resistan
Page 189 and 190:
and also by effecting blockade of t
Page 191 and 192:
attenuation of their BP lowering ef
Page 193 and 194:
(mean age, 54 years). Overall, ACE
Page 195 and 196:
glomerular capillary flow and thus
Page 197 and 198:
Similar to the ACE inhibitors the A
Page 199 and 200:
Direct Vasodilators There are 2 maj
Page 201 and 202:
once per week as a patch; thus, it
Page 203 and 204:
chlorthalidone: the antihypertensiv
Page 205 and 206:
with less side effects. 2 Two drug
Page 207 and 208:
Table 1: (Law et al., 2003 NKFM & M
Page 209 and 210:
Post-test questions Which of the fo
Page 211 and 212:
Table 1: 9 Identifying indicators o
Page 213 and 214:
to be more costly and sometimes una
Page 215 and 216:
13. Schroeder K, Fahey T, Ebrahim S
Page 217 and 218:
orthostatic hypotension, especially
Page 219 and 220:
markers (RF, Anti SS-A or SS-B) Ima
Page 221 and 222:
Key Points • OH is present in up
Page 223 and 224:
Baroreceptor Dysfunction Ankur Sand
Page 225 and 226:
lability. The wide fluctuations in
Page 227 and 228:
ETIOLOGY Resistant HTN in most of t
Page 229 and 230:
especially in elderly smokers who h
Page 231 and 232:
Loop diuretics In patients with und
Page 233 and 234:
3. Singer GM, Izhar M, Black HR. Go
Page 235 and 236:
HYPERTENSIVE URGENCY AND EMERGENCY
Page 237 and 238:
TABLE 1 Target Organ Damage associa
Page 239 and 240:
Table 2. Evaluation of Patient with
Page 241 and 242:
NEUROLOGICAL EMERGENCIES Acute Isch
Page 243 and 244:
CARDIAC EMERGENCIES Acute Coronary
Page 245 and 246:
3. Tisdale JE, Huang MB, Borzak S,
Page 247 and 248:
TREATMENT OF HYPERTENSION IN PATIEN
Page 249 and 250:
NDHP CCBs) may have decreased clear
Page 251 and 252:
the prototypic disease in which RAA
Page 253 and 254:
peripheral edema and pulmonary cong
Page 255 and 256:
therapy with spironolactone on prot
Page 257 and 258:
35. Liu M, Takahashi H, Morita Y, M
Page 259 and 260:
Learning Objectives: Hypertension i
Page 261 and 262:
and maternal morbidity and mortalit
Page 263 and 264:
Degree of Hypertension Management M
Page 265 and 266:
hydralazine, a direct vasodilator,
Page 267 and 268:
Hypertension Management Controversi
Page 269 and 270:
Figure 1 References 1. Prevention o
Page 271 and 272:
calcium antagonist would be much sa
Page 273 and 274:
What is the most likely cause of th
Page 275 and 276:
Physical Exam: BP sitting 120/74 mm
Page 277 and 278:
simply using renin angiotensin syst
Page 279 and 280:
~70 hours) will function down to a
Page 284:
National Kidney Foundation of Michi
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