INSTRUCTIONS Hypertension in 2014: Making sense of the guidelines
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Hypertension in 2014: Making sense of the guidelines
GENERAL PURPOSE: To review current hypertension guidelines. Learning Objectives: After reading the article and taking this test, you should be able to: 1. Identify the key differences between the 2013 ASH/ISH and JNC 8 hypertension publications. 2. Discuss hypertension management guidelines.
- In 2013, all of the following organizations published hypertension documentsexceptthe
- ASH and ISH.
- AHA, ACC, and CDC.
- The JNC 8 guidelines are based on
- expert opinion.
- AHA protocols.
- randomized clinical trials.
- longitudinal studies.
- JNC 8 researchers sought to answer whether health outcomes were improved by allexcept
- treating to specific BP goal.
- initiating therapy at specific BP thresholds.
- treating with specific medications.
- combining lifestyle changes with pharmacotherapy.
- A JNC 8 recommendation based on expert opinion or conflicting evidence is considered
- Grade A.
- Grade D.
- Grade E.
- Initiating pharmacologic treatment in the general population 60 years and older at a SBP of 150 mm Hg or higher or DBP of 90 mm Hg or higher was recommended at Grade
- For people under age 60, JNC 8 guidelines focus on
- weight control.
- What do JNC 8 guidelines recommend for initial pharmacologic therapy in the general Black population?
- thiazide-type diuretics or CCBs
- Initial or add-on therapy including ACEIs or ARBs is recommended by JNC 8 for
- all patients with diabetes.
- all patients with CKD.
- patients with kidney disease and diabetes.
- Black patients with kidney disease.
- Which condition is addressed in the ASH/ISH guidelines but not in JNC 8?
- resistant hypertension
- How do ASH/ISH guidelines define hypertension in adults over 80 years of age?
- BP of 140/90 mm Hg or higher
- DPB greater than 80 mm Hg
- SBP greater than 150 mm Hg
- SBP greater than 140 mm Hg
- What intervention is recommended by ASH/ISH guidelines for a patient with DBP between 80 and 89 mm Hg?
- counseling about lifestyle modification
- assessment for comorbidities
- ASH/ISH guidelines classify SBP of 160 mm Hg or higher or DBP of 100 mm Hg or higher as
- Stage I hypertension.
- Stage II hypertension.
- Stage III hypertension.
- ACEIs or ARBs are recommended by ASH/ISH as Stage I initial therapy in
- non-Black patients less than 60 years.
- Black patients less than 60 years.
- non-Black patients over 60 years.
- Black patients over 60 years.
- For patients with resistant hypertension, ASH/ISH recommends adding
- peripheral adrenergic inhibitors.
- What drug treatment does JNC 8 recommend for Black patients with diabetes mellitus?
- potassium sparing diuretics
- The AHA/ACC/CDC Science Advisory discusses the importance of developing and disseminating
- published expert opinion.
- electronic medical records.
- accreditation standards.
- evidence-based algorithms.
- Which of the following isnota key AHA/ACC/CDC Advisory principle for creating hypertension algorithms?
- An appropriate patient version should be included.
- The algorithm should be stable, not requiring periodic updating.
- The cost of monitoring and treatment should be considered.
- The format should be compatible with electronic health records.
- AHA/ACC/CDC advises developers that algorithms shouldnotbe used to
- overtreat a vulnerable population.
- make specific treatment recommendations.
- discourage nonpharmacologic interventions.
- counter the healthcare provider's clinical judgment.