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Chapter 1: Hypertension

According to the JNC8 guidelines, what is the BP goal for a 68-year-old hypertensive patient without any comorbid?

a. <130/80 mm Hg

b. <140/90 mm Hg

c. <150/90 mm Hg

d. <160/100 mm Hg

Answer c is correct. In the absence of other disease states, this is the goal for a hypertensive patient when referencing the JNC8 guidelines. This goal would also be supported by ASH/ISH.

Answer a is incorrect. This could be a possible secondary goal for those with high risk for CAD; however, there have been minimal studies to indicate this tightly controlled blood pressure improves cardiac outcomes.

Answer b is incorrect. This is the goal for the general population who are less than 60 years of age and who have uncomplicated hypertension.

Answer d is incorrect. No current guidelines support this BP as a target goal or any patients with hypertension. In fact a consistent blood pressure level such as this may increase the risk for cardiovascular disease including stroke.

Which of the following recommendations for lifestyle modification is correct?

a. A minimum weight loss of 15 lb

b. Sodium restriction of 4 g or less per day

c. Reduce alcohol intake to no more than two drinks a day for a woman, one for a man

d. Exercise for at least 30 minutes most days of the week

e. Adopt an eating plan low in potassium and ­carbohydrates

Answer d is correct. Thirty minutes per day is the minimum recommendation for physical activity in most patient populations. Regular physical activity can lower BP by 2 to 9 mm Hg. It is important to make sure that all patients have been clinically cleared to engage in physical activity by their primary care provider, cardiologist, or other responsible provider.

Answer a is incorrect. Although many patients may require a weight loss of 15 lb or more, the recommendation is to maintain normal body weight, which is a BMI of 18.5-24.9 kg/m2. Maintaining normal body weight can lower BP by 5 to 20 mm Hg/10 kg weight loss.

Answer b is incorrect. The recommendation is no more than 2.4 g of sodium per day. Restriction of sodium can decrease BP by 2 to 8 mm Hg.

Answer c is incorrect. Alcohol should be no more than one drink per day for a woman and two drinks per day for a man. A drink is considered to ...

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