Chapter 28: Hypertension

Question 1

What is hypertension? How common is it?

Answer 1

It is high blood pressure. It affects 1 in 3 people.

Question 2

Is hypertension symptomatic or asymptomatic?

Answer 2

It is asymptomatic for the majority of the time. Because of that, people usually don’t get treatment until something crazy happens.

Question 3

What are the antihypertensives that are approved for pregnant women?

Answer 3

• Labetalol
• Nifedipine
• Methyldopa

Question 4

When do we officially treat a pregnant woman with antihypertensives?

Answer 4

When their SBP is above 160 mmHg or their DBP is above 105 mmHg

Question 5

What medications cause hypertension?

Answer 5

• Cocaine
• Decongestants (Phenylephrine and Pseudoephedrine)
• NSAIDS
• Imunosupressants
• Systemic Steroids
• Erythropoietin-Stimulating Agents

Question 6

How do Beta-Blockers work?

Answer 6

Beta-Blockers work by blocking the beta-receptors of the myocardial tissue. This ultimately causes a decrease in HR and Contractility. This lowers blood pressure. There are selective beta-blockers that only act on the heart and non-selective beta-blockers that act upon the heart AND the peripheral tissues.

Question 7

What are some examples of selective beta-blockers?

Answer 7

Atenolol (Tenormin)

Metoprolol

Question 8

What are some examples of non-selective beta-blockers?

Answer 8

Propranolol (Inderal)

Carvedilol (Coreg)

Question 9

What are Centrally Acting Alpha-2 Adrenergic Agonists?

Answer 9

These drugs work by acting on the Alpha-2 Adrenergic receptors of the brain which then cause the brain to not release norepinephrine. This ultimately causes a decrease in HR and Contractility which then lowers blood pressure. We usually use these in individuals with resistant hypertension and in those that cannot tolerate oral medications. A good example would be Clonidine (Catapres) because it is available as a patch formulation.

Question 10

What are the side effects of centrally acting Alpha-2 Adrenergic Agonists?

Answer 10

• Dizziness
• Fatigue
• Somnolence
• Hypotension
• Dry Mouth
• Erythema (Patch)
• Priuritis (Patch)

Question 11

What do direct vasodilators do?

Answer 11

They cause vasodilation of the arterioles which then decreases blood pressure.

Question 12

What are some examples of Direct Vasodilators?

Answer 12

Hydralazine

Minoxidil

Question 13

What are side effects to watch out with when taking direct vasodilators?

Answer 13

Peripheral Edema
Headache
Flushing

Question 14

What do alpha blockers do?

Answer 14

They block alpha receptors in the arteries which decreases blood pressure. These are usually not used hypertension but can be. They are more used for benign prostatic hyperplasia.