1,022
edits
Changes
Jump to navigation
Jump to search
Line 66:
Line 66: − + − + − + − + − + + + +
→Hypertension
|}
|}
=Hypertension=
=Essential Hypertension=
* Primary/Essential Hypertension
* Primary/Essential Hypertension (95% of cases)
** Dx: Rule out secondary causes, BP > 130/90 on two separate occasions.
** Dx: Rule out secondary causes, BP > 130/90 on three separate occasions.
** DDx: Secondary HTN--RAS, Hypo/Hyper(para)thyroidism, Conn syndrome, Cushing's syndrome, Pheochromocytoma
** DDx: Secondary HTN (5% of cases; suspect if patient very young, very old, very high BP, or refractory to treatment)
** Tx: Can start with 1 or 2 agents depending on severity. First line: ACEI/ARB (good for kidney protection), (Non)Dihydropyridine CCB, Beta Blockers (cardiac selective, non-selective), Thiazide/Non-Thiazide Type Diuretics (second line)
*** Endocrine: [[Conn syndrome]] (most common), [[Cushing's syndrome]], [[Pheochromocytoma]], [[Hyperthyroidism]], [[Hyperparathyroidism]]
*** Renal: bilateral [[RAS]], [[PKD]], [[CKD]]
*** Other: [[Cocaine]], [[OSA]], [[OCPs]], [[Coarctation]]
** Tx: For SBP 121-139 or DBP 81-89, start with 8-12 weeks lifestyle modifications and reassess. Can start with 1 or 2 agents depending on severity. First line: ACEI/ARB (good for kidney protection), Dihydropyridine CCB > non-dihydropyridine CCB, Beta Blockers (cardiac selective (MAN BABES) > non-selective), Thiazide-Like Diuretics > Thiazide-Type Diuretics. Special populations: CHF (avoid CCBs, use beta blockers), CKD (use ACEI/ARB), Pregnancy (hydralazine, labetalol, nicardipine, methyldopa), post-MI (use beta blockers + ACEI/ARB), Blacks (CCB + thiazide-like diuretic)
* Hypertensive Urgency BP > 180
* Hypertensive Urgency BP > 180
* Hypertensive Emergency BP > 180 + symptoms
* Hypertensive Emergency BP > 180 + symptoms