Hypertension Secrets

Cover
IFC
Title Page
Copyright
Dedication
Contributors
Preface
Top 100 Secrets
Chapter 1 - Measurement of Blood Pressure in the Office
	Questions
		1 - What is office blood pressure measurement?
		2 - What are the major types of office BP measurement?
		3 - How should BP measurement be performed in the office?
		4 - What are the sources of error with office BP measurement?
		5 - How is AOBP monitoring performed?
		6 - What is the evidence for office BP as a predictor of cardiovascular outcomes, and how does it compare to out-of-office ...
		7 - What are the thresholds for normal vs. elevated BP values in the office in order to guide treatment?
		8 - What are the treatment threshold and treatment targets for AOBP?
		9 - What is the bottom line with respect to office BP measurement?
	References
Chapter 2 - Ambulatory and Home Blood Pressure Monitoring
	Questions
		1 - What is out-of-office blood pressure monitoring?
		2 - Why is out-of-office BP monitoring performed?
		3 - What is ABPM?
		4 - Why is ABPM performed?
		5 - How is ABPM performed?
		6 - How is ABPM interpreted?
		7 - What is HBPM?
		8 - Why is HBPM performed?
		9 - How is HBPM performed?
		10 - How is HBPM interpreted?
		11 - Are there important differences in the information obtained using ABPM vs. HBPM?
		12 - Does it matter what device is used to perform ABPM and HBPM?
	References
Chapter 3 - Clinical Evaluation of the Patient with Hypertension
	Questions
		1 - What are the objectives of clinical evaluation of a patient with hypertension?
		2 - What is the appropriate method to check blood pressure?
		3 - What are the appropriate requisites when taking blood pressure readings?
		4 - What pertinent information should be obtained during history taking in the patient who initially presents with hyperten...
		5 - What pertinent findings on physical examination should one look for during evaluation of a patient with hypertension?
		6 - What laboratory and diagnostic tests should be performed as part of hypertension evaluation?
		7 - Which patients require additional diagnostic testing?
		8 - What is pseudohypertension?
		9 - What is Osler maneuver?
	Bibliography
Chapter 4 - Hypertensive Emergencies and Urgencies
	Questions
		1 - What is a hypertensive emergency?
		2 - Why do hypertensive emergencies happen?
		3 - What is a hypertensive urgency and how does this differ from a hypertensive emergency?
		4 - What is the pathophysiology of a hypertensive emergency?
		5 - What is the role for the terms “accelerated hypertension”, “malignant hypertension”, and “hypertensive crisis”?
		6 - What are the common etiologies of hypertensive emergencies?
		7 - How do you assess for end-organ damage?
		8 - How do you lower blood pressure safely in a hypertensive emergency?
		9 - How do you lower blood pressure safely in a hypertensive urgency?
		10 - Is it safe to treat a patient with a hypertensive urgency as an outpatient?
		11 - When do I send my patient to the emergency room for high blood pressure?
	Bibliography
Chapter 5 - The Epidemiology of Hypertension
	Questions
		1 - What is the prevalence of hypertension?
		2 - Which groups have a higher risk of developing hypertension and its complications?
		3 - What are the risk factors for hypertension?
		4 - How does hypertension impact health outcomes?
		5 - What percentage of pregnant women are affected by hypertension?
		6 - What is the clinical significance of white coat hypertension?
		7 - How prevalent is masked hypertension?
		8 - What is the impact of resistant hypertension?
		9 - How often do patients have a secondary cause of hypertension?
	Bibliography
Chapter 6 - Physiology of Blood Pressure Regulation
	Questions
		Short-Term Regulation of Blood Pressure
			1 - What are the two components of measured blood pressure and what do they represent?
			2 - What is mean arterial pressure and its hemodynamic determinants?
			3 - What factors determine CO?
			4 - Define the Frank-Starling law of the heart?
			5 - What are the determinants of SVR?
			6 - What are the primary mechanisms involved in the short-term regulation of blood pressure?
			7 - What is the role of the baroreceptor reflex in regulation of MAP?
			8 - What is the role of chemoreceptors in the regulation of blood pressure?
			9 - Describe and indicate the mechanisms involved in the Bezold–Jarisch reflex.
			10 - What are the cardiovascular responses associated with emotion?
			11 - What is the effect of pain on blood pressure?
			12 - Describe the effect of exercise on cardiovascular response?
		Long-Term Regulation of Blood Pressure (Fig. 6.3)
			13 - What are the key factors in the long-term regulation of blood pressure?
			14 - What is pressure natriuresis?
			15 - What is juxtaglomerular apparatus and tubuloglomerular feedback? (Fig. 6.4)
			16 - How does tubuloglomerular feedback increase glomerular filtration rate? (Fig. 6.5)
			17 - How does tubuloglomerular feedback decrease GFR? (Fig. 6.6)
			18 - What is the concept of glomerulotubular balance?
			19 - What are the components of the RAS? (Fig. 6.7)
			20 - How are the plasma levels of renin regulated?
			21 - What are the hemodynamic effects of Ang II and its receptors?
			22. What are the various stimuli for aldosterone release?
			23 - What are the effects of aldosterone and how are they mediated?
			24 - What is the role of the kinin-kallikrein system (KKS) in blood pressure regulation?
			25 - What are endothelins and what role do they play in blood pressure regulation?
			26 - What is the role of prostaglandins in blood pressure regulation? (Fig. 6.8)
			27 - What are the roles of the skin and immune system in blood pressure regulation?
	Bibliography
Chapter 7 - Target Organ Damage or Why Should we Treat Hypertension?
	1 - Which organs are most affected by elevated blood pressure?
	2 - How does hypertension effect target organs?
	3 - What are the effects of hypertension on the heart and vasculature?
	4 - What are the effects of hypertension on the brain?
	5 - What are the effects of hypertension on the kidneys?
	6 - What are the effects of hypertension on the eyes?
	7 - How should patients be evaluated for target organ damage due to hypertension?
	8 - What factors increase the risk of target organ damage due to hypertension?
	9 - What can be done to reduce the risk of target organ damage due to hypertension?
	10 - How should hypertension be managed when target organ damage is already present?
	References
Chapter 8 - Primary Aldosteronism and Mineralocorticoid Hypertension
	Questions
		1 - What is the most common identifiable cause of resistant hypertension?
		2 - What patients should I evaluate for PA?
		3 - How often do patients with PA present without hypokalemia?
		4 - What are the most common causes of PA?
		5 - Why is it important to diagnose PA rather than just treat the hypertension?
		6 - What is the best initial screening test for PA?
		7 - How do antihypertensive medications and other conditions affect the ARR?
		8 - Do I need to withhold interfering medications before checking the ARR?
		9 - What additional testing should be done in a patient with an abnormal ARR?
		10 - How can you accurately differentiate between unilateral and bilateral causes of PA?
		11 - What is the treatment for aldosterone-producing adenoma?
		12 - How is bilateral adrenal aldosterone excess treated?
		13 - What mineralocorticoids other than aldosterone can cause hypertension, and when should this be considered?
	References
Chapter 9 - Glucocorticoid Hypertension
	Questions
		1 - What are glucocorticoids?
		2 - What are mineralocorticoids?
		3 - How do glucocorticoids influence blood pressure?
		Cushing Syndrome
			4 - What is Cushing syndrome?
			5 - Is Cushing syndrome common?
			6 - List the etiologies of Cushing syndrome.
			7 - Describe the clinical manifestations in Cushing syndrome.
			8 - Who should be tested for Cushing syndrome?
			9 - How do we test for Cushing syndrome?
			10 - What is pseudo-Cushing syndrome?
			11 - What are some other caveats of hypercortisolism testing?
			12 - How is the etiology of Cushing Syndrome established?
			13 - What are the treatment options for Cushing syndrome?
		APPARENT MINERALOCORTICOID EXCESS SYNDROME
			14 - What is apparent mineralocorticoid excess syndrome?
			15 - Describe the clinical and laboratory features of AME syndrome.
			16 - How is AME syndrome diagnosed?
			17 - What treatment options are available for patients with AME syndrome?
			18 - Are there nongenetic forms of HSD11B2 dysfunction?
			19 - What are the most common inhibitors of HSD11B2?
	Bibliography
Chapter 10 - Pheochromocytoma and Paraganglioma
	1 - What are pheochromocytoma and paraganglioma?
	2 - What are the differences between pheochromocytoma and paraganglioma?
	3 - What causes pheochromocytoma and paraganglioma?
	4 - What other tumors are associated with hereditary pheochromocytoma-paraganglioma syndromes?
	5 - What are the symptoms and signs of pheochromocytoma and paraganglioma?
	6 - Which patients should be tested for pheochromocytoma and paraganglioma?
	7 - How are pheochromocytoma and paraganglioma diagnosed?
	8 - Can false-positive testing results occur?
	9 - When and how should imaging be used in the evaluation of pheochromocytoma and paraganglioma?
	10 - What is the treatment for pheochromocytoma and paraganglioma?
	11 - What should I do if I think I have diagnosed a pheochromocytoma or paraganglioma?
	References
Chapter 11 - Other Endocrine Causes of Hypertension
	Questions
		1 - How does acromegaly cause hypertension, and when should it be suspected?
		2 - When should testosterone excess be suspected as a cause of hypertension?
		3 - How does PCOS cause androgen excess and hypertension, and how should it be treated?
		4 - Do thyroid disorders cause hypertension?
		5 - Does hyperparathyroidism cause hypertension?
		6 - Does recombinant erythropoietin administration cause hypertension?
		7 - Is there a link between polycythemia and hypertension?
	References
Chapter 12 - Renovascular Hypertension
	Questions
		1 - What is renovascular hypertension?
		2 - What is the prevalence of RVH?
		3 - What are the common and uncommon causes of RVH?
		4 - What is FMD?
		5 - Why does renal artery obstruction cause HTN?
		6 - What clinical signs suggest RVH and may prompt further testing?
		7 - What testing should be performed for evaluation of RVH?
		8 - What increase in creatinine with ACEi/ARB initiation is suggestive of RVH?
		9 - What additional testing is helpful after making a diagnosis of RVH?
		10 - What is the most appropriate initial treatment for RVH?
		11 - What are the indications for revascularization in atherosclerotic RVH?
		12 - When should revascularization be performed with FMD?
		13 - When should surgical revascularization be performed?
	References
Chapter 13 - Drug-Induced Hypertension
	1 - What are the four main mechanisms by which drug-induced hypertension may occur?
	2 - What drug classes cause hypertension by sympathomimetic activation?
	3 - What drug classes cause hypertension by mineralocorticoid activation?
	4 - What drug classes cause hypertension by direct vasoconstriction?
	5 - What drug classes cause hypertension as a withdrawal syndrome?
	6 - What hypertension-producing drugs do patients routinely omit from their medication list?
	7 - Which drugs of abuse cause or worsen hypertension and how?
	8 - How do stimulants cause or worsen hypertension?
	9 - Which antidepressants can cause or worsen hypertension and how?
	10 - Which headache treatments can cause or worsen hypertension and how?
	11 - What commonly used over-the-counter medication can cause or worsen hypertension?
	12 - What supplements can cause or worsen hypertension?
	13 - How does caffeine cause or worsen hypertension?
	14 - What does it mean for a corticosteroid to have glucocorticoid activity or mineralocorticoid activity?
	15 - How do glucocorticoids cause or worsen hypertension?
	16 - How do mineralocorticoids cause or worsen hypertension?
	17 - How do oral contraceptives cause or worsen hypertension?
	18 - How do antifungals cause or worsen hypertension?
	19 - How does licorice cause or worsen hypertension?
	20 - How do NSAIDs cause or worsen hypertension?
	21 - What cancer agents produce hypertension and how?
	22 - What immunosuppressive agents produce hypertension and how?
	23 - Abrupt discontinuation of which recreational drugs may result in hypertension?
	24 - Abrupt discontinuation of which medications may result in hypertension?
	25 - What drug-drug interactions can cause or worsen hypertension?
Chapter 14 - Obstructive Sleep Apnea and Hypertension
	QUESTIONS
		1 - What is obstructive sleep apnea?
		2 - How common is OSA?
		3 - What is the relevance of OSA in HTN?
		4 - What are the humoral and hemodynamic effects of OSA?
		5 - How should patients with suspected OSA in the setting of HTN undergo evaluation?
		6 - What are the treatment modalities for OSA in patients with HTN?
		7 - What are the effects of treatment of OSA on blood pressure in patients with HTN?
		8 - What is the effect of treatment of OSA on blood pressure in patients with resistant HTN?
		9 - What are important aspects of pharmacotherapy of HTN in patients with OSA?
	Bibliography
Chapter 15 - Hereditary Causes Of Hypertension
	QUESTIONS
		1 - How common are hereditary forms of hypertension?
		2 - When should genetic testing be pursued?
		3 - Which hereditary causes of hypertension present in pediatric populations?
		4 - Why do the majority of hereditary causes of hypertension tend toward hypokalemia?
		5 - How does familial hyperkalemic hypertension cause hyperkalemia?
		6 - Which monogenic cause of hypertension is not directly associated with renal salt handling?
		7 - Why is amiloride the ideal treatment for Liddle syndrome?
		8 - What genetic disorders are associated with pheochromocytoma/paraganglioma?
		9 - What secondary cause of hypertension is associated with Turner syndrome?
		10 - What somatic mutations are associated with hypertension?
	References
Chapter 16 - Hypertension in Children and Adolescents
	QUESTIONS
		1 - How is hypertension defined in children and adolescents?
		2 - How common is hypertension in children and adolescents?
		3 - What are the causes of hypertension in children and adolescents?
		4 - What factors contribute to the development of childhood primary hypertension?
		5 - What is the best approach for identifying children and adolescents with high BP?
		6 - How is the diagnosis of hypertension confirmed in children and adolescents?
		7 - How should hypertension in a child or adolescent be evaluated?
		8 - What is the recommended initial treatment for hypertension in children and adolescents?
		9 - When should antihypertensive medications be used in a child or adolescent with hypertension?
		10 - What medications can be used in children with hypertension?
		11 - How should children with hypertension be followed after treatment has been started?
		12 - What about sports participation?
		13 - Are there specific forms of childhood hypertension that require special consideration?
		14 - Does hypertension in childhood have implications for future cardiovascular health?
	Bibliography
Chapter 17 - Hypertension in Chronic Kidney Disease and End-Stage Kidney Disease
	QUESTIONS
		HYPERTENSION IN CHRONIC KIDNEY DISEASE
			1 - What is the prevalence of hypertension in chronic kidney disease?
			2 - How should BP be measured in the office in patients with CKD?
			3 - What is the role of ambulatory blood pressure monitoring and home BP monitoring in CKD?
			4 - What is the pathophysiology of hypertension in CKD?
			5 - What are the consequences of untreated hypertension in patients with CKD?
			6 - What is the target BP in CKD?
			7 - What are some of the nonpharmacologic treatment strategies that can be used in the treatment of hypertension in CKD?
			8 - Why is it important to restrict sodium intake in hypertensive patients with CKD?
			9 - What is the drug of choice for treatment of hypertension in patients with CKD and proteinuria?
			10 - On initiation of treatment with an ACEI/ARB, a rise in serum creatinine is often noted. Why does this occur, and what ...
			11 - Describe the role of diuretics in the treatment of hypertension in CKD.
			12 - What other antihypertensive drugs can be used in patients with CKD?
		HYPERTENSION IN END-STAGE KIDNEY DISEASE
			13 - What is the prevalence of hypertension in end-stage kidney disease?
			14 - What is the optimal timing of measurement of BP in patients on HD?
			15 - How is hypertension defined in patients with ESKD using the different methods of BP measurement?
			16 - What is the pathophysiology of hypertension in ESKD?
			17 - Describe the relationship between BP and the risk for cardiovascular events and death in patients on HD.
			18 - What are the nonpharmacologic interventions to control BP in patients with ESKD?
			19 - Discuss the role of antihypertensive medications in patients with ESKD.
			20 - How do you choose antihypertensive agents in patients with ESKD?
	Bibliography
Chapter 18 - Hypertension in Diabetes
	QUESTIONS
		1 - Is hypertension common in patients with diabetes?
		2 - What are the current guideline-oriented BP goals in patients with hypertension and diabetes?
		3 - What is the main evidence for current BP goals in patients with T2DM?
		4 - What is the evidence for BP goals in patients with T1DM?
		5 - How is hypertension treated in patients with diabetes?
		6 - How does diabetes cause diabetic nephropathy?
		7 - What is the evidence for efficacy of RAAS inhibition in diabetic nephropathy?
		8 - Do all patients with diabetes and chronic kidney disease have diabetic nephropathy?
		9 - How does one manage the side effects of RAAS inhibitors?
		10 - As most patients will require more than one antihypertensive drug, is dual RAAS blockade (ACE inhibitor + ARB) a good ...
		11 - What is the role of SGLT2 inhibitors in treating hypertension in patients with T2DM?
		12 - Should SGLT2 inhibitors be used in hypertensive patients with T2DM with diabetic nephropathy?
		13 - What is the side effect profile of SGLT2 inhibitors?
	Bibliography
Chapter 19 - Hypertension After Transplantation
	Questions
		1 - What is the definition of hypertension in transplant recipients?
		2 - What is the incidence and prevalence of hypertension after transplantation?
		3 - What is the clinical importance of hypertension in kidney transplant recipients?
		4 - What is the pathogenesis of hypertension after kidney transplantation?
		5 - What are the risk factors for hypertension after kidney transplantation?
		6 - How do CNIs affect hypertension after transplantation?
		7 - How do steroids affect hypertension after transplantation?
		8 - How does belatacept affect hypertension after transplantation?
		9 - What is the goal of blood pressure after kidney transplantation?
		10 - What is the significance of low diastolic blood pressure on kidney transplant recipients?
		11 - What approaches should be utilized for treatment of hypertension after kidney transplantation?
		12 - How should calcium channel blockers be utilized in the treatment of hypertension after kidney transplantation?
		13 - How should diuretics be used in the treatment of hypertension after kidney transplantation?
		14 - How should ACEIs and Ang II receptor blockers be used in the treatment of hypertension after kidney transplantation?
		15 - Discuss the role of beta-blockers in the treatment of hypertension after kidney transplantation.
	Bibliography
Chapter 20 - Treatment of Hypertension in Obesity
	Questions
		1 - What is the epidemiology of obesity and hypertension?
		2 - How does obesity cause and/or aggravate hypertension?
		3 - What is the impact of the nonpharmacologic (and nonsurgical) intervention to obesity treatment over hypertension?
		4 - What are the effects of antiobesity drugs in hypertension?
		5 - What BP measurement technique should be used in patients with obesity?
		6 - What are the treatment options for overweight and obesity grade 1?
		7 - Which is the best treatment option when the baseline BMI is greater than 35 kg/m2?
		8 - Does bariatric surgery reduce BP?
		9 - How should hypertension be managed in the perioperative period of a bariatric surgery?
		10 - Is there a better surgical technique for a patient with hypertension?
	References
Chapter 21 - Hypertension in Blacks
	Questions
		1 - What is the prevalence of hypertension in Blacks in the United States?
		2 - Does hypertension have an earlier age of onset in Blacks in comparison to Whites?
		3 - How does the hypertension in Blacks compare with the hypertension in Whites?
		4 - Why is hypertension more prevalent and severe in Blacks compared with Whites?
		5 - What laboratory tests and results are helpful in directing treatment for Black patients?
		6 - Should renin (or renin activity) be measured in all Blacks with hypertension?
		7 - Should aldosterone also be measured?
		8 - Can a different approach to treating hypertension lead to better outcomes for Black patients?
		9 - Spironolactone vs. eplerenone—which one is preferred?
		10 - Why are drugs that reduce ENaC activity so underutilized?
		11 - Amiloride and triamterene are used mostly as potassium-sparing agents in patients. How effective are they as antihyper...
		12 - To what extent are these drugs accepted by patients?
	Bibliography
Chapter 22 - Hypertension in the Elderly
	Questions
		1 - What is the epidemiology of hypertension in the elderly?
		2 - What are some issues of specific importance when evaluating elderly hypertensive patients?
		3 - What is the distribution of hypertensive subtypes in elderly patients?
		4 - What is the major mechanism of ISH in the elderly?
		5 - What is the role of salt sensitivity in the elderly?
		6 - Are there differences in benefit from treatment of hypertension in the elderly compared to younger patients?
		7 - What should the BP treatment targets be for elderly patients?
		8 - How does low DBP affect the treatment decisions in ISH?
		9 - Does frailty modify BP goals?
		10 - Is the approach to antihypertensive drug therapy different for older patients?
		11 - Are there drugs that specifically target ISH?
		12 - What impact does hypertension treatment have on cognition?
		13 - Are there concerns about increased adverse effects from antihypertensive drugs in elderly patients?
	Bibliography
Chapter 23 - Hypertension in Pregnancy
	Questions
		1 - How does pregnancy normally affect blood pressure?
		2 - Describe the classification of hypertension disorders that occur in pregnancy.
		3 - When should secondary causes of hypertension be considered as the cause of hypertension in pregnancy?
		4 - How do you diagnose preeclampsia?
		5 - What is HELLP syndrome?
		6 - What are risk factors for developing preeclampsia?
		7 - What is currently known about the pathogenesis of preeclampsia?
		8 - What can be done to prevent preeclampsia?
		9 - What can be done to treat preeclampsia?
		10 - What are potential complications of preeclampsia?
		11 - What is the target BP in pregnant patients?
		12 - Which antihypertensive agents have acceptable safety profiles to be used in pregnancy?
		13 - Which antihypertensive agents should be avoided in pregnancy?
		14 - What considerations to type of antihypertensive agents should be made in breastfeeding women?
	Bibliography
Chapter 24 - Hypertension in Heart Disease
	Questions
		Treatment of Hypertension in Patients with Coronary Artery Disease and Stable Angina Pectoris
			1 - How does hypertension and its management contribute to coronary artery disease?
			2 - What drugs are recommended for the treatment of hypertension in patients with CAD?
			3 - What are the determinants of coronary artery blood flow, and how would this impact your management of patients with hyp...
			4 - How would consideration of the determinants of CBF impact your management of patients with hypertension and CAD?
			5 - Does the data on low DBP extend to clinical trial data?
			6 - What is the impact of left ventricular hypertrophy on CBF in hypertension?
			7 - Why are patients with aortic regurgitation and accompanied increase in SBP and markedly reduced DBP not experiencing ma...
		Hypertension in Patients with Acute Coronary Syndromes
			8 - What is the impact of hypertension on the prognosis of patients with acute myocardial infarction, and does antihyperten...
		Treatment of Hypertension in Patients with Heart Failure
			9 - What is the main current way to categorize heart failure?
			10 - Which drugs are useful in lowering BP and reducing cardiovascular mortality in patients with hypertension and heart fa...
			11 - What is the target BP for patients with heart failure and hypertension, and what is the evidence for it?
			12 - Does the level of initial BP influence treatment with BP-lowering drugs in HFrEF?
	Bibliography
Chapter 25 - Hypertension in STROKE
	QUESTIONS
		1 - What is the epidemiology of stroke?
		2 - What are the major classifications of stroke and which types are associated with hypertension?
		3 - What are the risk factors for stroke?
		4 - What is the “acute hypertensive response in stroke?”
		5 - How should hypertension be managed in the setting of an acute stroke?
		6 - Does hypertension affect decision making for acute thrombolysis in acute stroke?
		7 - Does hypertension treatment prevent first and recurrent stroke?
		8 - What is the role of hypertension in cerebral aneurysm development and rupture?
		9 - Which antihypertensive agents should be preferred or avoided in intracerebral hemorrhage?
		10 - How should blood pressure be managed differently in the setting of severe intracranial atherosclerosis?
		11 - Which antihypertensive agents should be preferred or avoided in ischemic stroke?
		12 - What is PRES and how should it be treated?
	References
Chapter 26 - Hypertension in the patient with aortic dissection
	Questions
		1 - What are the acute aortic syndromes?
		2 - What are the risk factors for AAS?
		3 - What are typical presenting symptoms for the patient with an acute AoD?
		4 - How should blood pressure be assessed in the patient with an AAS?
		5 - What are unique causes of hypertension in AAS?
		6 - Do all patients with AAS need aggressive treatment of hypertension?
		7 - What medications are recommended for hypertension control in acute AoD?
		8 - What are the goals of hypertension control prior to repair?
		9 - What are the goals of BP management in acute AoD?
		10 - What is the mechanism by which AAS cause complications?
		11 - What happens to the aorta over time in patients with AoD?
		12 - What happens to the aorta over time in patients with IMH and PAU?
		13 - What medications are recommended in patients with AAS in the chronic setting?
		14 - Does hypertension predict dissection recurrence and aneurysm formation?
	References
Chapter 27 - Resistant and pseudoresistant hypertension
	QUESTIONS
		1 - What is the prevalence of resistant hypertension?
		2 - What is the definition of RH?
		3 - What is the definition of pseudo-RH?
		4 - What is the CV risk associated with RH?
		5 - What is the pathophysiology of RH?
		6 - What is the work-up for RH?
		7 - What is the best pharmacologic management of RH?
		8 - What is the role of device therapy for RH?
	Bibliography
Chapter 28 - Hyperkalemia in Hypertension
	Questions
		1 - Why is hyperkalemia important to understand in the management of individuals with ­hypertension?
		2 - How does the body normally manage potassium?
		3 - Define the electrocardiographic changes associated with hyperkalemia.
		4 - How should one approach the hypertensive patient with hyperkalemia?
		5 - What is the role of dietary modification in the prevention of hyperkalemia?
		6 - Define the role of proper diuretic use in mitigation of hyperkalemia.
		7 - How can newer potassium-exchange resins be used in hypertensive individuals with hyperkalemia on RAAS inhibitors?
	References
Chapter 29 - Lifestyle Modifications for Hypertension Management
	Questions
		1 - What is the role of lifestyle modifications in the treatment of hypertension?
		2 - How do you follow a low-sodium diet?
		3 - How do you calculate how much sodium is in foods or beverages?
		4 - How effective is the DASH diet?
		5 - Is the DASH diet more effective with the addition of sodium restriction?
		6 - Can the DASH diet be used in patients with diminished kidney function to lower BP?
		7 - Does the Mediterranean diet result in BP effects?
		8 - Does the Nordic diet result in BP effects?
		9 - Does the Ketogenic diet result in BP effects?
		10 - Does intermittent fasting result in BP effects?
		11 - Does the high potassium diet result in BP effects?
		12 - What are the recommendations for alcohol consumption to reduce BP?
		13 - What effect does heavy alcohol intake have on BP?
		14 - What role does smoking have on BP?
		15 - What is the pathophysiology of obesity-related hypertension?
		16 - What impact does weight loss have in reducing BP?
		17 - What is the role of physical exercise in hypertension?
		18 - How effective is OSA treatment in reducing BP in hypertension?
		19 - What alternative approaches may be beneficial in treating hypertension?
	Bibliography
Chapter 30 - Blood Pressure Treatment Goals
	Questions
		1 - Why is a treatment goal important for hypertension?
		2 - What was the established treatment goal up to 2017, and what was the evidence?
		3 - What new findings contributed to the establishment of new BP treatment goals in 2017?
		4 - What is the new general BP treatment goal for hypertension?
		5 - Is there additional evidence for a goal of less than 130/80 mm Hg since publication of the 2017 ACC/AHA BP guideline?
		6 - What is the current BP treatment goal for adults of 65 years of age or older and why?
		7 - What is the current BP treatment goal for patients with CKD/end-stage kidney disease and why?
		8 - What is the current BP treatment goal for patients with diabetes and why?
		9 - What is the current BP treatment goal for patients who have had a stroke?
		10 - What is the current BP treatment goal for patients with coronary artery disease and heart failure?
		11 - Is there a risk of reducing BP to or below goal in some patients?
		12 - Is there benefit of lowering BP even though the goal may not be met?
		13 - How can I overcome therapeutic inertia?
		14 - What is the best way to monitor the BP goal?
	References
	Bibliography
Chapter 31 - Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blocker
	Questions
		1 - Describe the mechanism of action of antiogensin-converting enzyme inhibitors and angiotensin receptor blockers?
		2 - What differences are seen with regard to the renin-angiotensin-aldosterone system with ACE inhibitors and ARBs? How is ...
		3 - What is the effect of an ACE inhibitor or ARB on glomerular filtration rate?
		4 - In which patient populations is there a proven benefit of using ACE inhibitors or ARBs?
		5 - What is the effect of an ACE inhibitor or ARB on proteinuria?
		6 - What are the potential adverse effects of ACE inhibitors or ARBs?
		7 - In which patient populations should these medications be used with caution?
		8 - Is there any benefit to combined ACE inhibitor and ARB therapy?
	Bibliography
Chapter 32 - Calcium Channel Blockers
	Questions
		1 - How do calcium channel blockers exert their antihypertensive effect?
		2 - Explain the classification system for dihydropyridine-CCBs.
		3 - Nifedipine and amlodipine are often used interchangeably. What are the clinically relevant differences between them?
		4 - Name key trials that support the efficacy and safety of CCBs.
		5 - Can dihydropyridine (e.g., amlodipine) and nondihydropyridine (e.g., diltiazem) be prescribed in combination?
		6 - Are there indications for CCBs apart from hypertension?
		7 - Discuss the potential advantages of CCBs compared to other classes of antihypertensives.
		8 - In which populations should CCBs be prescribed with caution?
		9 - Describe the common adverse effects of CCBs.
		10 - With which commonly prescribed medications do CCBs interact?
	Bibliography
Chapter 33 - Direct vasodilators
	Questions
		Direct smooth muscle arterial vasodilators
			1 - What is a direct smooth muscle arterial vasodilator?
			2 - What is the mechanism of action of direct arterial vasodilators?
			3 - What are the hemodynamic changes associated with direct vasodilators?
			4 - What are the important pharmacokinetic parameters of direct vasodilators?
			5 - What are the side effects of direct vasodilators?
			6 - What monitoring is required for patients taking vasodilators?
			7 - When are direct vasodilators contraindicated?
			8 - What is the level of evidence for using direct smooth muscle arterial vasodilators?
			9 - What is the role of hydralazine in the critical care setting?
			10 - How is hydralazine used in managing hypertension in pregnancy and during lactation?
			11 - What is the benefit of hydralazine in combination with nitrates in the treatment of patients with congestive heart fai...
			12 - What is the role of hydralazine in patients with renal dysfunction?
	Bibliography
Chapter 34 - Loop and thiazide diuretics
	Questions
		1 - What is the mechanism of action of thiazide diuretics?
		2 - What is the mechanism of action of loop diuretics?
		3 - Why are thiazides more effective at reducing blood pressure than loop diuretics?
		4 - What are the most commonly used loop diuretics and how are they dosed?
		5 - What are the most commonly used thiazide diuretics and how are they dosed?
		6 - Do outcomes differ between different thiazide diuretics?
		7 - What are common side effects of loop diuretics?
		8 - What are common side effects of thiazide diuretics?
		9 - Why do thiazide diuretics cause hypercalcemia?
		10 - Why do thiazide diuretics cause hyponatremia more often than loop diuretics?
		11 - Why do diuretics increase the risk of gout?
	REFERENCES
Chapter 35 - Potassium-sparing diuretics
	Questions
		1 - How do potassium-sparing diuretics work?
		2 - Why is this class of diuretics called potassium-sparing diuretics?
		3 - What are the generic names for potassium-sparing diuretics?
		4 - What are common indications for potassium-sparing diuretics?
		5 - How are potassium-sparing diuretics dosed?
		6 - What are the most common side effects and contraindications to the use of potassium-sparing diuretics?
		7 - What drug interactions should be considered before using potassium-sparing diuretics?
	References
Chapter 36 - Alpha antagonists
	Questions
		1 - How do alpha adrenergic receptors contribute to blood pressure regulation?
		2 - Why are quinazoline-derived selective alpha-1 receptor antagonists preferred in modern hypertension management over non...
		3 - Why is doxazosin preferred over other quinazoline-derived alpha antagonists? What are the important pharmacokinetic par...
		4 - How should doxazosin be dosed in typical antihypertensive patients?
		5 - What clinical outcomes can be expected in patients using doxazosin for hypertension control?
		6 - What clinical trial data support the use of alpha antagonists?
		7 - When would alpha antagonists be a preferred treatment option?
		8 - When should alpha antagonists not be used? And what are the side-effects or adverse events to anticipate in patients us...
		9 - Where do alpha antagonists fit in the contemporary management of hypertension?
		10 - Are there any drug interactions with doxazosin?
	References
	Bibliography
Chapter 37 - Beta-blockers
	Questions
		1 - What is the clinical pharmacology of β-adrenergic receptor blockers?
		2 - How are individual β-adrenergic receptor blockers different from each other?
		3 - What are common adverse effects seen with use of β-blockers?
		4 - How has the recommendation for beta-blockers changed with time for hypertension?
		5 - What is the clinical trial evidence for beta-blockers use in hypertension?
		6 - What is the evidence for beta-blockers use for preventing progression of kidney failure?
		7 - What is the evidence for beta-blockers use for management of heart failure in CKD?
		8 - What is the evidence for beta-blockers use in management of hypertension in dialysis?
		9 - What are the practical aspects in the use of beta-blockers for management of hypertension in CKD?
	References
Chapter 38 - Alpha-2 Agonists
	Questions
		1 - How do alpha-2 agonists reduce blood pressure?
		2 - Which medications act primarily as alpha-2 agonists?
		3 - When prescribing an alpha-2 agonist, what are the usual doses?
		4 - What are the most common side effects of alpha-2 agonists?
		5 - What issues can arise when discontinuing alpha-2 agonists?
		6 - How does alpha-2 agonist rebound hypertension (drug withdrawal) present?
		7 - How can alpha-2 agonist rebound hypertension (drug withdrawal) be prevented or treated?
		8 - What conditions, other than hypertension, are treated by use of alpha-2 agonists?
		9 - What commonly used muscle relaxer is primarily an alpha-2 agonist?
		10 - Should an alpha-2 agonist be the preferred agent in specific settings?
		11 - Should these drugs be avoided in certain settings?
	References
Chapter 39 - Drug-Drug and Pharmacogenetic Interactions
	Questions
		1 - What are the possible mechanisms by which medications or supplements affect antihypertensive medication effectiveness?
		2 - What commonly used drugs are associated with drug interactions with antihypertensive medications?
		3 - How does rifampin interact with antihypertensive mediations, and how should you alter treatment?
		4 - Are there any known genetic variants that affect antihypertensive medication effectiveness?
		5 - What genetic variants alter the risk of antihypertensive medication side effects?
		6 - Are there any genetic variants that should be tested for prior to starting an antihypertensive medication?
	References
Chapter 40 - Role of Device Therapy
	Questions
		1 - What do we mean by device therapies in hypertension?
		2 - What is the history of interventions for hypertension?
		3 - How does renal denervation work?
		4 - What is the current evaluation of the effect of renal denervation?
		5 - What are the possible advantages of renal denervation over medications?
		6 - What about long-term efficacy and effect on clinical outcomes?
		7 - What are the potential safety issues or disadvantages of renal denervation?
		8 - Why was there a discrepancy between early studies and later?
		9 - Who should have renal denervation?
		10 - What is the evidence in baroreceptor stimulation or modulation?
		11 - What is the role of a central arteriovenous fistula in controlling hypertension?
		12 - What are the other device therapy options that have been tried?
	References
Chapter 41 - Orthostatic Hypotension
	Questions
		1 - What physiologic responses prevent blood pressure from decreasing acutely when we stand?
		2 - What is orthostatic hypotension?
		3 - How should blood pressure be measured to diagnose OH?
		4 - Describe the most common causes of OH.
		5 - How should a differential diagnosis be established for orthostatic hypotension in a hypertensive patient?
		6 - Which patients are most likely to develop neurogenic OH?
		7 - What are the best clinical assessments for accurately diagnosing neurogenic OH?
		8 - What are the characteristic clinical findings in patients with neurogenic OH?
		9 - What are the physical examination findings commonly observed in patients with neurogenic OH?
		10 - Describe the most commonly used therapeutic agents to treat OH.
		11 - What additional factors must be considered for hospitalized patients?
		12 - How is OH managed in a patient with severe hypertension?
		13 - What are the best pharmacological agents used to treat supine hypertension in the setting of autonomic failure?
	References
Chapter 42 - Baroreflex Dysfunction
	Questions
		1 - What is the baroreflex?
		2 - How does the baroreflex respond to increased blood pressure?
		3 - How does the baroreflex respond to decreased blood pressure?
		4 - What role does the baroreflex play in the long-term control of blood pressure?
		5 - How is baroreflex function assessed?
		6 - What is the Valsalva maneuver?
		7 - What role does the baroreflex play in hypertension?
		8 - How does baroreflex function change with age?
		9 - How does baroreflex function change with obesity?
		10 - Is the role of the baroreflex in hypertension different between men and women?
		11 - What is baroreflex dysfunction?
		12 - What is efferent baroreflex dysfunction (a.k.a. autonomic failure)?
		13 - What is afferent baroreflex dysfunction?
			Etiology
			Presentation
			Management
	References
Chapter 43 - Hypertension – Origins
	Questions
		1 - When did hypertension enter medical nosography as a disease?
		2 - How did the measurement of blood pressure evolve?
		3 - How were the effects of hypertension on organs recognized?
		4 - How did the treatment of hypertension evolve?
	Bibliography