Primary HTN appears to be related to heredity modified by environmental factors such as ____________. A. dietary sodium B. obesity C. stress D. All of the above. All of the following statements relative to secondary HTN are correct EXCEPT which one? A. About 5-10% of patients with high BP have secondary BP. B. Secondary HTN has an identifiable and potentially correctable cause. C. Alcohol has a beneficial effect on secondary HTN. D. Whenever a patient is diagnosed with high BP, one purpose of the initial assessment is to exclude possible secondary causes. Which of the following statements about HTN in the U.S. is correct? A. More than 68 mission people in the U.S., i.e., one in three adult, have HTN. B. It is estimated that 70% of the patients with HTN have SBP between 140-159 mmHg and DBP between 90-99 mmHg. C. About 30% of American adults have prehypertension, i.e., SBP between 120-139 mmHg and DBP between 80-89 mmHg. D. All of the above. According to the JNC-7, a patient with a SBP ≥160 or DBP ≥100 _______________. A. has stage 2 HTN B. has prehypertension C. has stage 1 HTN D. will require health-promoting lifestyle modifications to reduce their risk of developing HTN The basic evaluation for patients with elevated BP includes _______________. A. a review of the medical history B. physical examination C. routine laboratory testing D. All of the above. The mercury manometer is the _______________. A. most accurate B. does not require recalibration C. standard for measuring BP D. All of the above. All of the following statements about the technique of measuring the BP are correct EXCEPT which one? A. The patient’s arm should be abducted, slightly flexed, and supported by a smooth, firm surface. B. Ideally, the BP should be measured after the patient has rested comfortably for at least 30 minutes. C. The brachial artery over which the BP is to be recorded should be at a level with the heart. D. SBP is the point at which the first Korotkoff sound is heard (onset of phase 1), and the disappearance of Korotkoff sound (onset of phase 5) is used to define DBP. All of the following statements are correct relative to the changing patterns of BP with increasing age EXCEPT which one? A. The rise in SBP continues throughout life. B. The DBP rises until age 50, then levels off over the next decade, and may remain the same or fall later in life. C. DBP is a more potent cardiovascular risk factor than SBP after age 50. D. The pulse pressure reflects the numerical difference between SBP and DBP. Major lifestyle modifications shown to lower BP include _______________. A. aerobic exercising B. adopting a diet rich in fruits, vegetables, and low-fat dairy products C. reduction of dietary sodium D. All of the above. All of the following statements are correct with respect to the pharmacological strategies to treat high BP EXCEPT which one? A. If goal BP is not achieved with lifestyle modification drug therapy is imitated with a thiazide diuretic, a calcium channel blocker, an angiotensin-converting enzyme inhibitor, or an angiotensin receptor blocker. B. More than two-thirds of hypertensive individuals cannot be controlled by one drug alone, especially if the BP is 20/10 mmHg above goal. C. Once drug therapy is initiated, patients require follow-up and adjustment of medications at monthly intervals until the BP is at target. D. After the BP is at goal and stable, further follow-up visits are not necessary. According to the ACC/AHA, the preferred perioperative cardiovascular risk assessment of patients about to undergo a noncardiac procedure should be based on _______________. A. patient-specific factors B. procedure specific factors C. exercise (functional) capacity of the patient D. All of the above. Which of the following statements is correct with respect to hypertension-related cardiovascular risk of patients undergoing noncardiac procedures? A. It is well established that BP in the range of 140/90- 179/1090 mmHg is not an independent risk factor for perioperative cardiovascular complications in association with noncardiac procedures. B. In association with other recognized minor predictors/markers for cardiovascular disease and the presence of clinical risk factors, an awareness of the patient’s elevated BP should lead to a higher suspicion of CAD. C. Patients with uncontrolled systemic HTN should be referred for routine medical evaluation and risk modification. D. All of the above. All of the following statements are correct with respect to severely elevated BP EXCEPT which one? A. Patients with severely elevated BP are at increased risk for the development of uncontrolled systemic HTN. B. Severely elevated BP is defined as SBP >180 mmHg or DBP >110 mmHg. C. When patients present with severely elevated BP, clinicians should first differentiate hypertensive emergency and severe asymptomatic HTN. D. Severely elevated BP tends to develop gradually over days, week, or months. All of the following statements are correct with respect of severe asymptomatic HTN EXCEPT which one? A. Severe asymptomatic HTN is defined as severely elevated BP without signs and symptoms of target-organ damage. B. Severe asymptomatic HTN should be further classified as hypertensive urgency or severe uncontrolled HTN. C. Hypertensive urgency is defined as the presence of risk factors for progressive target-organ damage, e.g., unstable angina, congestive heart failure, or preexisting renal insufficiency. D. Patients with severe uncontrolled HTN should be referred to a physician within 24-48 hours. All of the following statements are correct with respect to hypertensive emergency EXCEPT which one? A. Hypertensive emergency is defines as severely elevated BP and signs and symptoms of target-organ damage. B. Patients with signs and symptoms of target organ damage require admission to an intensive care unit within one to two hours for immediate treatment. C. In the emergent setting, i.e., the oral healthcare setting, the BP should be acutely lowered while waiting for the EMS to arrive. D. Signs and symptoms of target-organ damage include visual disturbances, dyspnea, chest pain, and seizure. All of the following statements are correct with respect to white coat hypertension EXCEPT which one? A. WCH is characterized by transient elevation of SBP of up to 20 mmHg and DBP elevations by up to 10 mmHg precipitated by a vigorous sympathetic response to the medical or dental setting. B. WCH is noted in about 20-35% of patients diagnosed with HTN. C. The risk of major cardiovascular events in patients with WCH is equivocal. D. Patients suspected of WCH and no evidence of target organ damage are candidates for ambulatory blood pressure monitoring (ABPM). All of the following statements are correct with respect to orthostatic hypertension EXCEPT which one? A. OH is commonly defined as a supine-to standing BP decrease >20 mmHg systolic or >10 mmHg diastolic. B. OH is one of the least common medical emergencies in the oral healthcare setting. C. Because OH has been shown to be a significant risk factor for syncope, falls, and increased age-adjusted mortality, patients with OH should be referred to physician for focused examination and appropriate risk modification. D. Since antihypertensive medications and meals can cause major BP reductions in susceptible patients, it is prudent to schedule dental appointment 30-60 minutes after ingestion of medications and meals. All of the following statements are correct with respect to procedure-specific risk factors EXCEPT which one? A. The BP should be monitored closely if general anesthesia is being administered to individuals on antihypertensive medications because of potential wide fluctuation in BP and the risk of a hypertensive crisis. B. There are no adequately controlled or randomized clinical trials that help define dental procedure-specific hypertensive or other cardiovascular risks. C. There is some evidence that in general the risks associated with dental procedures are comparable to those associated with a spectrum of medical procedures provided in ambulatory settings. D. A systematic review of the literature concluded that the use of epinephrine in local anesthetic agents has minimal effect on BP. All of the following statements are correct with respect exercise capacity EXCEPT which one? A. Exercise (functional) capacity, expressed in METs, is an individual’s capacity to perform a spectrum of common daily tasks. B. A person who can climb a flight of stairs, without experiencing shortness of breath, diaphoresis, pallor, or tightness in the chest has a functional capacity of 8 METs. C. The hemodynamic effect of infiltration anesthesia with 0.045 mg of epinephrine was found to be equivalent to 4 METs. D. 4.5 cc of local anesthetic agent with epinephrine 1:100,000 can be administered safely to a patient whose functional capacity is ≥4 METs. Within the context of an effective wellness program in oral health care settings, which of the following reflects an appropriate recommendation and follow-up if the initial BP of a patient without acute target organ damage was 120-139/80-90 mmHg? A. Provide advice about lifestyle modifications and minimally reevaluate BP in two years. B. Provide advice about lifestyle modifications and minimally reevaluate BP in one year. C. Provide advice about lifestyle modifications and reevaluate BP in two months. D. Refer for medical evaluation within one month.