michigan hypertension core curriculum - State of Michigan

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B Hypertensive Adults (rate, percent + SE) 100 80 60 40 20 0 P< vs. Figure 2; 30 Table 2. Major Cardiovascular Risk Factors in African Americans Behavioral markers that increase for development of high blood pressure1,7 Smoking Obesity Inactivity Excessive alcohol intake High dietary intake of fat and sodium Low dietary intake of potassium Clinical makers associated with high blood pressure1,7,25 Low birth weight Family history of CD, diabetes, or premature heart disease High-normal blood pressure (130-139/85-89 mm Hg) Adult weight gain Major risk factors for CHD28,30,52 Smoking Elevated blood pressure (whether treated or untreated) Elevated serum total cholesterol or LDL-C levels Low serum HDL-C level Diabetes mellitus Advancing age Obesity Inactivity Additional important risk factors for CD1,32 History of cardiovascular event (MI, stroke, revascularization) Kidney disease Evidence of target-organ damage (proteinuria, LVH, L heart failure, TIA, peripheral arterial disease, atherosclerosis, retinopathy) Male or postmenopausal woman Family history of CVD in women aged
Table 5. Therapeutic Lifestyle Changes Medical Target Realistic Personal Plan to Achieve Goal Normal weight for height Lose weight gradually by making permanent change in daily diet for the entire family. Set a reasonable weight loss goal (even 5-10 lb [2.2-4.5 kg] can make a difference). Eat fewer fast food and fried foods, and eat more fruits and vegetables. Dietary goals: Eat more grains, fresh fruits, and vegetables. Low fat Eat fewer overall fats and healthier fats, such as olive oil. Low sodium Eat fewer processed foods and fast foods. High potassium Read labels and pay attention to the sodium and fat content of foods. Adequate calcium Identify high-sodium foods (eg. potato chips or hot dogs) that can be comfortably omitted. Identify low-sodium, high-potassium snacks (eg. dried fruits, bananas, orange juice, raw vegetables). Do not salt foods when cooking; instead, taste foods fi rst and add salt at the table if needed. Use vinegar or lemon juice instead of salt for seasoning. Do not season foods with smoked meats, such as bacon or ham hocks. Become more aware of food sources that are rich in calcium. If lactose intolerant, try lactose-free milk or yogurt, or drink calcium-fortifi ed juices or soy milk. Limit alcohol Men: no more than 2 beers, 1 glass or wine, or 1 shot of whiskey (or hard liquor) per day. Women: no more than 1 beer or 1 glass of wine per day (a shot of whiskey exceeds these recommendations). Physical fi tness Increase physical activity as part of the daily routine; eg, if currently sedentary, get off the bus 6 block from home, or walk in the evening with a spouse or friend. Gradually increase time spent at an enjoyable activity to 30-45 min at least 5 days a week. No tobacco use For nonsmokers, do not start. For current smokers, attempt smoking cessation, increase tolerance for failure, and be willing to continue the effort until success is achieved. Be aware that smokeless tobacco products (eg, chewing tobacco) also have associated risks. Table 2: 18 < If BP
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MICHIGAN HYPERTENSION CORE CURRICUL
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April 2010 Dear Colleague: In 2005,
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Kevin L. Piggott, MD, MPH, FAAFP Pr
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Blood Pressure Measurement........
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10 Hypertension Core Curriculum Blo
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of the wrist. Additionally, there i
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asis. National guidelines recommend
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Post-Test Questions: 1. High BP is
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18 Hypertension Core Curriculum Ess
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Masked Hypertension is when the off
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TABLE 1. Prevalence of Awareness, T
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Blood Pressure, Circulatory Physiol
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side of the vascular tree. Arterial
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Page 30 and 31: Table 3. Clinically Available Clues
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Page 36 and 37: cause greater disruption of CBF aut
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Page 42 and 43: development of essential HTN can se
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Page 46 and 47: Table 2 Table 3 Screening Test for
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Page 52 and 53: side effects particularly well. A h
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Page 62 and 63: References: 1. Association AD. All
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Page 68 and 69: Figure 1: Table 1. Metabolic Syndro
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Page 72 and 73: Incidence and Prevalence The overal
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Page 76 and 77: As a part of the approach to managi
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Page 84 and 85: appear to be related to access to c
Page 86 and 87: CDC MMWR Feb 24, 2006/55(07); 177-1
Page 88 and 89: Figure 1; Clinical presentation and
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Page 92 and 93: ANY patient, who develops paroxysma
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Page 98 and 99: Definition Prevalence Clinical Feat
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Page 104 and 105: Figure 3; Endocrine Society See tex
Page 106 and 107: INTRODUCTION 106 Hypertension Core
Page 108 and 109: Renal manifestations. Renal ischemi
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Page 124 and 125: Table 1. Contemporary evaluation of
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Manifestations of vital organ injur
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Table 6. Clinical evaluation of ren
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Table 9. Assessment of worsening re
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Table 11. New terminology for renal
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References: 1. Murphy TP, Soares G,
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2001;12(6):1235-1241. 40. Subramani
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78. Tami LF, McElderry MW, al-Adli
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142 Hypertension Core Curriculum Pr
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monitored hypertension screening an
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Policy Development: Public health p
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Med Clin North Am. Jan 2004;88(1):2
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mind they will have no problem iden
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Role of Race in the Selection of An
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individuals of any race or ethnicit
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Older Patients Need Elevated Systol
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sister, mother and father. A family
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ecause pressure-related retinopathy
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pulses (lower in the left arm). 4 C
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Vital signs suggestive of OSAHS. 20
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may shed light on underlying medica
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References: patients. 8 However, th
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Objectives: 170 Hypertension Core C
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and evidence that anti-hypertensive
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When subjects are given instruction
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interestingly found only a 6.0/4.6
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pressure: a meta-analysis of random
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isolated systolic hypertension have
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Compelling Indications for Specific
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3.) Beta-blockers, ACE inhibitors,
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treatment levels - albeit though at
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Preparations and Dosage: Oral antih
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Preparations and Dosages: The Oral
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patients with tachy-brady syndrome
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significant proteinuria. Pharmacolo
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the effect found by the ACE inhibit
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and nominally statistically signifi
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sensitive K+-channels in vascular s
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clonidine (Catapres†) 0.1-0.8 mg
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Learning Objectives 204 Hypertensio
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general, the response to beta-block
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Table 2: (JNC VII, 2004) 208 Hypert
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Learning objectives: 210 Hypertensi
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ecently published RCT investigated
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Post-test question: 35y/o male w/ h
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Orthostatic Hypotension Pretest que
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BP. It is important to note that la
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1- Fludrocortisone : a mineralocort
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References: 1. Hiitola P, Enlund H,
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www.neuroanatomy.wisc.edu/.../Image
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Learning objectives: 226 Hypertensi
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controlled BP to have been victimiz
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Treatment of Secondary Causes of Hy
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4-Direct vasodilators (e.g.minoxidi
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Hypertension. Aug 2003;42(2):161-16
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emergency by virtue of the associat
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PATHOPHYSIOLOGY The underlying mech
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trials included a placebo arm. Seve
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an indication for careful and modes
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ACUTE KIDNEY INJURY (AKI) In additi
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Blood Pressure Research Council, an
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[ACE inhibitors (ACEIs), angiotensi
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y sodium restriction or the use of
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44 months 24 , and were also seen i
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• Hypertension in dialysis patien
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GISEN Group (Gruppo Italiano di Stu
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258 Hypertension Core Curriculum
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DEFINITION AND CLASSIFICATION Hyper
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etween adult socioeconomic position
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women treated with atenolol in earl
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Obstet Gynecol. Dec 12 2008. 5. Vol
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able to dissipate the pressure rise
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Use of Dihydropyridine Calcium Anta
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272 Hypertension Core Curriculum Ca
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Case 4 Hypertensive patient with CK
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Case 6 276 Hypertension Core Curric
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year. Sodium restriction and weight
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What may be causing these new sympt
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