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PC HTN (causes (Alcoholism (AHA no more than 2 drinks day men 1 for women…

- - - - acts on angiotensinogen to cleave off the ten-amino-acid peptide Angiotensin I.
        
        Angiotensin-converting enzyme (ACE) acts on this peptide to create peptide Angiotensin II,
        
        vasoconstriction
        
        Adrenl Cortex-aldosterone secretion
  - - - autosomal dominant cause of early-onset hypertension with normal or high aldosterone and low renin levels
      - aldosterone antagonists are effective in controlling hypertension
    - - autosomal dominant condition characterized by early-onset hypertension, hypokalemic alkalosis, low renin, and low aldosterone levels.
- - - - BP normal but doesn't dip at night
        
        Maybe stroke. Need Tx
    - - Obtain a blood pressure every visit.
        Recheck in clinic if >130/>80.
        Leave alone if <130/<80
        
        140-159/90-99 ->Repeat in ~2 weeks. Educate TLC x 3 months w/wo anti-HTN Rx
        ≥160/≥100->Repeat in ~2 weeks. HTN, Educate TLC, Initiate anti-HTN Med
        
        130-139/81-89 ->Borderline HTN, Counsel TLC
    - - 10
        
        pt talking
      - 5-10
        
        Full bladder
        
        feet not on floor
        
        back unsupported
        
        forearm BP
        
        legs crossed
        
        small cuff
  - - - Kidney disease
        Pheochromocytoma-benign adrneal tumor
        Coarctation of aorta
        Thyroid/parathyroid disease
        Primary aldosteronism (often in patients with DMT2)
        Obstructive sleep apnea
        Rx related (e.g., NSAIDs, cold remedies, some antidepressants)
        steroid therapy
      - cushing's
        
        purple straiae
        
        hirsutism in women, ED in men
        
        buffalo hump
  - - - more HTN, less repsonse to ACE inhibitors
    - - Diastolic less of a factor at age 50+
      - Black persons with hypertension and older patients tend to have lower plasma renin activity, which may be associated with expanded intravascular volume.
  - - - albumin
      - creatinine
- - - - disrupt RAAS
  - - - 5-20 mmHg per 10 kg
    - - 8-14 mmHg
    - - 4-9 mmHg 30+ min most days if not already doing it
      - Don't increase f, intensity & duration all on same day
      - if incrèments at least 10 min
- - - - swollen axons
  - - - CHF