The hypertension guidelines recommend that high risk patients should begin medications if their average BP is ≥130/80 mmHg. For lower risk patients (no history of cardiovascular disease or an ASCVD risk <10%) medications are recommended for primary prevention when their average BP is ≥140/90 mmHg.
The most recent American College of Cardiology/ American Heart Association clinical practice guidelines define hypertension as systolic BP greater or equal to 130 mmHg or diastolic BP greater or equal to 80 mmHg. Patients are then classified as having either stage 1 or stage 2 hypertension. Stage 2 usually requires medication in addition to lifestyle modifications to control blood pressure. If the diastolic and systolic blood pressure readings fall into different classifications, the higher classification is used. To make a clinical diagnosis of hypertension, two or more blood pressure readings obtained over two or more visit must fall into a particular classification (but not during acute illness or pain).
Risk Factors: include age 55 and older, family history of chronic venous insufficiency, high body mass index, venous reflux in deep veins, medical history of (pulmonary embolism, superficial or deep vein thrombosis, lower extremity skeletal or joint disease), multiple pregnancies, physical inactivity, and a history of venous ulcers.
Corticosteroids may be used to treat a variety of conditions and symptoms in the palliative care patient, including cerebral edema, spinal cord compression, pain, nausea/vomiting, malignant bowel obstruction, fatigue, and loss of appetite.
***Tumor edema is a common complication of primary or metastatic brain tumors and may cause significant symptoms of elevated intracranial pressure, such as headache, altered mental status, and seizures. Tumor edema may be secondary to tumor cell death, tumor growth, or related to treatment (for example, postoperative edema). The mainstay of therapy for brain tumor edema is systemic corticosteroids, most commonly dexamethasone. ***