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Hypertension guidelines: Evidence-based treatments for maintaining blood pressure control

doi: 10.1097/01.NPR.0000466250.66601.b2
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INSTRUCTIONS Hypertension guidelines: Evidence-based treatments for maintaining blood pressure control


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Lippincott Williams & Wilkins, publisher of The Nurse Practitioner journal, will award 2.5 contact hours for this continuing nursing education activity.

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Hypertension guidelines: Evidence-based treatments for maintaining blood pressure control

General Purpose: To provide information about the latest JNC-8 guideline for treating hypertension in adults. Objectives: After completing this continuing education activity, you should be able to: 1. Describe the scope of the problem using JNC-8 definitions of HTN. 2. Identify JNC-8 guideline goals for patients with HTN. 3. State the antihypertensive medication recommendations for various populations.

  1. After age 64, prevalence of HTN is
    1. greater in men.
    2. greater in women.
    3. about equal in men and women.
  2. Approximately what percentage of adults in the United States with HTN have uncontrolled BP?
    1. 25%
    2. 50%
    3. 75%
  3. Which patient demographic is most likely to have uncontrolled BP?
    1. Mexican American males
    2. Black females
    3. Black males
  4. The number of individuals in the United States who have HTN is approximately
    1. 12 million.
    2. 38 million.
    3. 78 million.
  5. The JNC-8 writing group developed the guideline based on
    1. the JNC-7 guideline.
    2. observational studies.
    3. evidence from randomized controlled trials.
  6. What is the JNC-8 recommended threshold to start BP medication in the general population?
    1. 130/85 mm Hg
    2. 140/85 mm Hg
    3. 150/90 mm Hg
  7. For a patient in the general population with a BP of 146/90 mm Hg on a thiazide-like diuretic, what medication should be added?
    1. none
    2. ARB
    3. ACE-I
  8. A patient with a prior history of stroke should have a BP goal of
    1. less than 130/80 mm Hg.
    2. less than140/90 mm Hg.
    3. less than 150/90 mm Hg.
  9. DBP goal for adults less than 60 years of age is
    1. less than 80 mm Hg.
    2. less than 85 mm Hg.
    3. less than 90 mm Hg.
  10. For patients with CKD or diabetes, JNC-8 recommends starting medication to achieve an SBP goal of
    1. less than 120 mm Hg.
    2. less than 140 mm Hg.
    3. less than 150 mm Hg.
  11. Which phrase is not part of the JNC-8 definition of “general population”?
    1. with or without diabetes
    2. non-Black
    3. with no history of HTN
  12. Which first-line therapy is associated with better outcomes?
    1. thiazide-like diuretic
    2. CCB
    3. ACE-I
  13. Which of the following could be used as first-line HTN therapy for Black Americans?
    1. alpha-blocker
    2. beta-blocker
    3. CCB
  14. Which of the following is the best choice as first-line HTN therapy for any patient with CKD?
    1. thiazide-like diuretic
    2. ACE-I
    3. CCB
  15. Which of the following combinations should be avoided in patients with CKD?
    1. CCB and ARB
    2. ACE-I and CCB
    3. ACE-I and ARB
  16. If prescribers are concerned about worsened kidney function due to BP management, which is the best medication choice?
    1. thiazide-like diuretic
    2. ARB
    3. beta-blocker
  17. Once therapy has been started, how long should a clinician wait before making therapy adjustments?
    1. 2 weeks
    2. 4 weeks
    3. 2 months
  18. Which of the following is a JNC-8 recommendation?
    1. Use the 2013 AHA/ACC guidelines on lifestyle management.
    2. Use out-of-office BP readings to confirm readings and diagnose HTN.
    3. Antihypertensive medications should always be started one at a time.


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