Term
| What is defined as hypertension? |
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Definition
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Term
| Are symptoms always seen with hypertension? |
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Definition
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Term
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Definition
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Term
| What is hypertension in children and adolescents defined as? |
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Definition
| elevated blood pressure that persists on repeated measurement at the 95th percentile or greater for age, height, and gender |
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Term
| Who can make the diagnosis of hypertension and prescribe treatment? |
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Definition
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Term
| What is the most common primary diagnosis in america? |
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Definition
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Term
| How much of the population has hypertension? |
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Definition
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Term
| Have the rates of hypertension risen or fell? |
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Definition
| did fall but rose again in the 90's |
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Term
| What is diagnosis and treatment based off of? |
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Definition
| usbed to just be based off of diastolic, but based off of systolic now too |
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Term
| Does systolic or diastolic increase with age? |
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Definition
| systolic rises throughout life, diastolic increases until about 50 |
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Term
| What race has the highest prevalence? |
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Definition
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Term
| What is primary hypertension caused by? |
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Definition
| no known cause(90% of cases) |
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Term
| What can play an important role in the severity and progression of hypertension? |
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Definition
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Term
| What is the basic underlying defect in primary hypertension? |
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Definition
| a failure in the regulation of vascular resistance |
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Term
| What is the underlying problem in systolic hypertension? |
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Definition
| the underlying problem is one of central arterial stiffness and loss of elasticity |
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Term
| What is blood pressure measured with? |
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Definition
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Term
| Are there always symptoms seen with hypertension? |
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Definition
| no, sometimes the only symptom is the actual high blood pressure reading |
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Term
| What is systolic pressure? |
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Definition
| Pressure at the peak of ventricular contraction |
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Term
| What is diastolic pressure? |
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Definition
| represents the total resting resistance in the arterial system after passage of the pulsating force produced by the contraction of the left ventricle |
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Term
| What is the difference between the systolic and diastolic pressure called? |
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Definition
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Term
| What is the Mean arterial pressure? |
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Definition
| the sum of the diastolic pressure plus one-third the pulse pressure |
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Term
| Before 50 hypertension is defined as.. |
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Definition
| an elevation in systolic AND diastolic |
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Term
| Who is isolated systolic pressure found in? |
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Definition
| most common form in people older than 50, rarely found in young adults |
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Term
| What is isolated diastolic pressure a risk factor for? |
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Definition
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Term
| What may be an early indication of hypertension? |
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Definition
| fundoscope examination of the retina |
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Term
| When symptoms are seen what are they? |
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Definition
| headache, tinnitus, and dizziness |
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Term
| What are late signs and symptoms related to? |
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Definition
| involvement of various target organs(kidney, brain, heart, eye) |
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Term
| What is Malignant hypertension? |
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Definition
| a medical emergency and requires immediate intervention |
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Term
| What is Hypertensive encephalopathy characterized by? |
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Definition
-headache
-irritability,
-alterations in consciousness
-signs of central nervous system (CNS) dysfunction
-enlargement of the left ventricle |
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Term
| What lab tests should patients with hypertension be regularly screened with? |
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Definition
-12-lead electrocardiogram
-Urinalysis
-Blood glucose
-Hematocrit
-A serum potassium, creatinine, calcium, and lipid profile |
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Term
| What is the classification and diagnosis of blood pressure based on? |
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Definition
| average of 2 or more readings while the patient is seated in two different visits |
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Term
| What is the most common method of taking blood pressure? |
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Definition
| auscultatory method (the one we use) |
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Term
| How are patients with prehytension treated? |
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Definition
| generally not with medication, but with lifestyle changes |
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Term
| What is the goal of the treatment of hypertension? |
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Definition
| to have a blood pressure less than 140/90 (in patient with kidney disese of diabetes it should be less than 130/80) |
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Term
| What is the common ddrug to treat hypertension? |
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Definition
| Thiazide diuretics are most often the first drugs of choice, given either alone or in combination with ACEIs, ARBs, BBs, or CCBs, depending on the degree of elevation of blood pressure |
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Term
| What is the blood pressure where people may need emergency treatment? |
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Definition
| 180/120, require it to go down in 1 hour, go to ICU |
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Term
| What is the primary concern of dental management of a person with hypertension? |
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Definition
| during the course of treatment, a sudden, acute elevation in blood pressure might occur, potentially leading to a serious outcome, such as stroke or MI |
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Term
| According to The American College of Cardiology and the American Heart Association practice guidelines, the determination of risk includes evaluation of which three factors? |
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Definition
-The risk imposed by the patient’s cardiovascular disease
-The risk imposed by the surgery or procedure
-The risk imposed by the functional reserve or capacity of the patient |
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Term
| What is uncontrolled blood pressure defined as? What is it considered? |
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Definition
| >180/110, considered minor risk condition |
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Term
| What is high risk? Intermediate? Low? |
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Definition
High= >5% risk
Intermediate= 1%-5% risk
Low=<1% risk |
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Term
| What is risk greatest with? |
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Definition
-vascular or emergency surgery -prolonged procedures
-procedures associated with excessive blood loss and general anesthesia |
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Term
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Definition
| Head and neck surgery,which may include major oral and maxillofacial procedures and extensive periodontal procedures |
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Term
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Definition
| Superficial surgical procedures, which include minor oral and periodontal surgery and nonsurgical dental procedures |
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Term
| What is the MET associated with risk? |
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Definition
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Term
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Definition
| climbing a flight of stairs |
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Term
| Patients with blood pressures less than 180/110 mm Hg... |
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Definition
| can undergo any necessary dental treatment, both surgical and nonsurgical, with very little risk of an adverse outcome |
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Term
| For patients found to have asymptomatic blood pressure of ≥180/110 mm Hg (uncontrolled hypertension)... |
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Definition
| elective dental care should be deferred; physician referral for evaluation and treatment within 1 week is indicated |
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Term
| What are some problems seen in people with uncontrolled hypertension that may neccessitate dental treatment? |
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Definition
| pain, infection, or bleeding(patient should be managed with physician) |
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Term
| WHat lessen the chances of endogenous release of catecholamines during the dental visitlessen the chances of endogenous release of catecholamines during the dental visit |
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Definition
| stress reduction techniques |
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Term
| How can anxiety be managed? |
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Definition
| with a benzodiazepine such as triazolam (Halcion), taken 1 hour before the start of the dental appointment |
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Term
| What is an excellent intraoperative anxiolytic for use in patients with hypertension? |
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Definition
| nitrous oxide mixed with oxygen |
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Term
| During treatment of a patient with upper-level stage 2 hypertension, it may be advisable to... |
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Definition
| leave the blood pressure cuff on throughout treatment, if it rises above 179/109 then terminate treatment |
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Term
| What is something we need to consider for the chair position of hypertensive patients? |
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Definition
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Term
| Who is anesthesia generally recommended for? |
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Definition
-ASA I (status of a healthy, normal person)
--or--
-ASA II (presence of mild to moderate systemic disease) |
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Term
| Can epinephrine be used on hypertensive patients? |
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Definition
| yes(2 cartilages, 1:100,000) |
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Term
| What medication should be avoided in hypertensive patients? |
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Definition
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Term
| What can effect the efficacy of anti-hypentisive drugs? |
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Definition
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Term
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Definition
| 180/110 requires med con before treatment, 140/90 should go see doctor but don't require med con before we see them |
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Term
| What are some oral signs of hyertension? |
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Definition
-excessive bleeding
-dry mouth(meds)
-lichnoid drug reaction
-slow healing
-gingivl overgrowth(CCblockers) |
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