HTN and IHD

Question 1

ACEI (antiHTN)

Answer 1

AgII inhib » vasodilation and decreased aldo

uses: CHF, LVH, DM (renoprotective)
CI: renovasc/stenosis
SE: cough, hyperK, angioedema, worse renal function

Question 2

ATRA

Answer 2

prevent AgII action

uses: ACEI intolerant (cough)
SEs: hyperK, renal impairment, angioedema

Question 3

CCB

Answer 3

AVN block » decreased HR (RL-CCB), SM vasodilation;

uses: >55/black, isolated HTN, angina
SEs: headache, flush, hypotension, ankle oedema, worsen CHF

Question 4

TZD

Answer 4

inhibit NaCl symporter in DCT » decreased volume + vasodilation; ineffective in renal impairment (require excretion);

SEs: hypoK, postural hypoTN, gout, impaired glucose control

Question 5

HTN management

Answer 5

A/C RULES

• lifestyle, confirm
• A/C » A+C » A+C+D » ACD + another D/spironolactone/AB/BB
• target

Question 6

IHD with CVD risk (secondary prevention)

Answer 6

anti-platelet (aspirin/clopidogrel)
anti-HTN (A/C rules)
lipid reduction (statin)
symptomatic relief (GTN spray)
unstable angina = LMWH added

Question 7

IHD prevention

Answer 7

BB/CCB (reduce HR and BO, vasodilate, increase coronaries)

BB/CCB +/- nicorandil/ISMN/ivabradine/ranolazine

Question 8

to add:

Answer 8

drug details
STEMI: acute, LT
angina
check guidelines