40 years old male , came anxious to the clinic , previous history of drug abuse , before coming to the clinic , had one large CAPPUCINO with extra shot, BP 160/95, a diagnosis of HTN is established if ???????
45 years old male with DM , Prior history of IHD, Last echo report EF 45%, SBP 155, Creatinine 140, potassium 4, started on lisinopril 10 mg po daily, after 3 month on a routine visit SBP 115, creatinine 155, potassium is 4.5 , No chest Pain or SOB, the next step will be ????
Difference between Hypertensive Urgency & Emergency
Hypertensive Emergency Is any Significantly SBP with sx Treatment start immediately, avoid sublingual Nifedipine. Refer to ER
Hypertensive Urgency is BP above 230/120 without sx, BP should come down to target within 24-48 Hours
Algorithm for Treatment of Hypertension (JNC 7) JAMA, May 2003 Not at Goal Blood Pressure (<140/90 mmHg) (<130/80 mmHg for those with diabetes or chronic kidney disease) Initial Drug Choices Lifestyle Modifications Drug(s) for the compelling indications With Compelling Indications Stage 2 Hypertension 2-drug combination for most Stage 1 Hypertension Thiazide-type diuretics for most. May consider ACEI, ARB, BB, CCB, or combination Without Compelling Indications
60 years old university teacher is working in university of london , he is married with children , not diabetic , not asthmatic , migrated from Nigeria, labeled as first stage of HTN, SBP 150, according to UK guidelines for HTN , the first line will be ?
22 years old lady with para 5, H/O Pregnancy induced HTN, seen one week after the delivery of twins by C/S, she is SOB , anxious & little bit sweaty , PaO2sat 92%, the best step in mangement will be????
A- give propranolol 10 mg po stat.
B-IV line ,check D-Dimer, High flow oxygen & call ER.