CHS Hypertension in Special Populations

Question 1

Which antihypertensive medication is contraindicated during pregnancy?

Accepted Answer

ACE inhibitors

Answer

ACE inhibitors are absolutely contraindicated during pregnancy, especially in the second and third trimesters. Their use can cause severe fetal renal abnormalities, oligohydramnios, growth restriction, and even fetal death, making them unsafe for pregnant patients.

Question 2

What is the first-line treatment for hypertension in African American patients without CKD?

Accepted Answer

Thiazide diuretics or calcium channel blockers

Answer

Current guidelines recommend thiazide diuretics or calcium channel blockers as first-line treatment for hypertension in African American adults without chronic kidney disease. This recommendation is based on evidence showing these classes are generally more effective in this population compared to ACE inhibitors or ARBs for initial therapy.

Question 3

Which condition defines hypertension in children?

Accepted Answer

BP ≥ 95th percentile for age, sex, and height

Answer

In children, hypertension is defined by blood pressure readings that are consistently at or above the 95th percentile for their age, sex, and height. This percentile-based approach accounts for the significant variations in normal blood pressure across different developmental stages in pediatric populations.

Question 4

Which hypertensive disorder is specific to pregnancy?

Accepted Answer

Preeclampsia

Answer

Preeclampsia is a serious hypertensive disorder that is unique to pregnancy, typically developing after 20 weeks of gestation. It is characterized by new-onset hypertension accompanied by proteinuria or other signs of end-organ dysfunction, posing significant risks to both mother and fetus.

Question 5

In elderly patients, which antihypertensive class is commonly associated with orthostatic hypotension?

Accepted Answer

Alpha-blockers

Answer

Alpha-blockers work by relaxing blood vessels, which can lead to a significant drop in blood pressure upon standing, known as orthostatic hypotension. This effect is particularly pronounced in elderly patients due to age-related changes in baroreflex sensitivity and vascular compliance, increasing their risk of falls.

(CHS) Certified Hypertension Specialist Practice Test

(CHS) Certified Hypertension Specialist Practice Test

CHS Hypertension in Special Populations