Resistant hypertension

 

1.      All are included in the definition of resistant hypertension as per Indian Hypertension Society Guidelines III recommendations:

a)      Unable to attain BP <140/90 mm of hg in overall population

b)      Unable to attain BP <130/80 mm of hg in DM and CKD cases

c)      2drugs +1 diuretic at maximum tolerable dose

d)      3 drugs + 1 diuretic at maximum tolerable dose

e)      Does not include newly detected case of systemic hypertension

f)       Needs at least two or three elevated readings in office settings despite adherence

 

 

2.      Overall prevalence of resistant hypertension is likely to be :

a)      13%

b)      30%

c)      1%

d)      43%

 

3.      All are “Pseudo resistance” EXCEPT:

a)      Suboptimal BP recording techniques

b)      White coat effect

c)      Poor adherence to antihypertensive

d)      Thick walled arteries in elderly (Osler’s sign)

 

4.      All statements about White Coat hypertension are correct EXCEPT:

a)      Its benign and can be ignored

b)      25% people with HTN in office show normalisation of BP in Ambulatory BP monitoring

c)      It is a cause for pseudo resistant hypertension

d)      Office BP recording is higher than home / ambulatory BP recordings

 

5.      All are pathophysiological basis for Resistant hypertension EXCEPT:

a)      Obesity

b)      Insulin resistance

c)      Sodium retention

d)      Increased sympathetic nervous system activity (SNS)

e)      Increased aldosterone sensitivity due to visceral obesity

f)       OSA

g)      Young age (<65 years)

 

6.      NSAIDs are notorious in causing resistant hypertension because

a)      Inhibit prostacyclin synthesis

b)      Decrease renal blood flow

c)      Sodium and water retention

d)      Counter acts all anti hypertensives except calcium channel blockers

e)      COX-2 inhibitors are also causative

f)       All of the above

 

7.      The most common medical cause for Resistant hypertension is :

a)      Renal parenchymal disease

b)      Renal artery stenosis

c)      Primary hyperaldosteronism

d)      OSA

e)      Phaeochromocytoma

f)       Cushing syndrome

g)      Hyper/hypo parathyroidism

h)      Aortic coarctation

i)       Intracranial tumors

 

8.      All statements are true regarding medications in resistant hypertension  EXCEPT:

a)      At least one of the antihypertensive should be given bedtime

b)      Night time antihypertensive gives better 24hour mean BP control than day time dosage

c)      24 hour mean BP is a good cardiovascular morbidity marker

d)      Twice daily dosage of ARB/ACE id better than OD dosage

e)      None of the above

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