23: Anti-hypertensive drugs

Question 1

Which diseases is hypertension a major risk factor for?

Answer 1

• Stroke
• Coronary artery disease
• Renal disease

Question 2

___% adults over age 65 are hypertension

Answer 2

50

Question 3

What are the two branches of treatment for hypertension?

Answer 3

• Lifestyle (diet, weight loss, exercise, reduce alcohol)

- Drug therapy

Question 4

What are some problems with hypertension treatment?

Answer 4

• Lifelong disease
• Asymptomatic
• Drug adherence
• Medication side effects

Question 5

What is target blood pressure

Answer 5

<140/90

Question 6

What is considered optimum therapy for hypertension?

Answer 6

ACEi + diuretic (thiazide) + vasodilator (ca channel blocker, alpha blocker)

Question 7

On which anti-hypertensive drugs is it important to monitor K levels?

Answer 7

• ACEis/ARBs
• Thiazide diuretics
• Spironolactone (hyperkalemia)

Question 8

Which type of Ca channel blocker is most commonly used for hypertension?

Answer 8

Vasodilators (nifedipine, felodipine, amlodipine)

Question 9

What are the targets of:

• Thiazide diuretics
• Loop diuretics
• Spironolactone

Answer 9

T = Na/Cl channel in DCT
L = Na/K/Cl in loop of Henle
S = aldosterone

Question 10

What is a centrally acting anti-hypertensive used in pregnancy?

Answer 10

Methyldopa

Question 11

When should you treat hypertension?

Answer 11

• If BP >160/100 on multiple occasions

- >140/90 + target organ damage, comorbidities, 10 years >20% CVS risk

Question 12

According to ABCD, how should you treat younger non-afrocarribbean patients (<55 years)?

Answer 12

• A or B (ACEi or beta blocker)

Question 13

Which drugs should be used for:

• Hypertension + heart failure
• Hypertension + angina/heart failure
• Hypertension + prostatism

Answer 13

• ACEi + diuretics
• Beta blockers
• Alpha blockers

Question 14

Which anti-hypertensives are contraindicated in pregnancy?

Answer 14

• ACEi/AIIA (renal agenesis)
• Atenolol (IUGR)
• Diuretics (reduced placental flow)