HYPERTENSION

Question 1

blood pressure is elevated enough to perfuse tissues and organs

Answer 1

HYPERTENSION

Question 2

What are the Classification of Hypertension

Answer 2

Normal: <120 <80
Pre hypertension: 120-139 80-89
Stage 1: 140 - 159 90 - 99
Stage 2: Greater than 160 Greater than 100
HTN Crisis: >180 mmHg or >120 mmHg

Question 2

Incidence:

Answer 2

PRIMARY HYPERTENSION
SECONDARY HYPERTENSION

Question 3

Physiology:

Answer 3

Blood Pressure = CO (Cardiac Output) x TPR ( Total Peripheral Resistance)

Question 4

Formula for Cardiac Output

Answer 4

SV ( Stroke Volume) x HR ( Heart Rate)

Question 5

Complications:

Answer 5

1.) Cardiac Effects
a.) Left ventricular Hypertrophy
b.) Accelerated Atherosclerosis
2.) Renal Effects
3.) Cerebral Effects
4.) Retinal Effects

Question 6

PREDISPOSING FACTORS

Answer 6

• Family history
• Patient history
• Racial predisposition
• Obesity
• Smoking
• Stress
• Sedentary lifestyle
• Intake of fats and salts

Question 7

Patient’s history and other physical findings suggest an underlying cause of hypertension

Answer 7

Secondary Hypertension

Question 8

DIAGNOSTICS

Answer 8

CBC
Lipid Profile
UA (HDL, LDL, Triglycerides)
SGOT
SGPT
Na
K
Ca
BUN
BUA
FBS & RBS
CREA
HBA1C

Question 9

General Principle:

Answer 9

to lower blood pressure toward NORMAL with minimal side effects and to prevent or reverse organ damage

Question 10

Candidates for Treatment:

Answer 10

Patients with diastolic >90 mmhg and systolic of >140 mmhg

Question 11

MOA: inhibition of the conversion of angiotensin 1 to angiotensin 2

Answer 11

ACE INHIBITORS

Question 12

ACE INHIBITORS examples

Answer 12

Captopril, enalaparil (enalaprilat), fosinopril,
lisinopril, dolapril, perindopril, etc.

Question 13

MOA: works by blocking the binding of
Angiotensin 2 to the receptor

Answer 13

ANGIOTENSIN RECEPTOR BLOCKERS

Question 14

ANGIOTENSIN RECEPTOR BLOCKERS examples

Answer 14

Telmisartan, Losartan, olmesartan, valsartan, etc.

Question 15

MOA: Blocks Beta adrenergic system

Answer 15

BETA BLOCKERS

Question 16

Whites with high cardiac output, high heart rate and normal vascular resistance
respond the best with beta blockers

Answer 16

BETA BLOCKERS

Question 17

Beta blockers must be used cautiously in patients with

Answer 17

DM, Reynaud’s syndrome & Neurological
Disorder

Question 18

MOA: Inhibits influx of calcium through slow channels in vascular smooth muscle and cause relaxation

Answer 18

CALCIUM CHANNEL BLOCKERS

Question 19

These agents must be used with extreme caution or not at all in patient with conductive disturbances involving SA and AV node.

Answer 19

NON - DIHYDROPYRIDINE

Question 20

MOA: blocks the peripheral postsynaptic Alpha-1 adrenergic receptor.

Answer 20

PERIPHERAL ALPHA -1 ADRENERGIC
ANTAGONIST

Question 21

Given to HTN patients who have not responded to initial HTN therapy.

Answer 21

PERIPHERAL ALPHA -1 ADRENERGIC
ANTAGONIST

Question 22

MOA: act primarily within the CNS on alpha 2 receptors to decrease sympathetic outflow to the cardiovascular system

Answer 22

CENTRALLY ACTIVE ALPHA AGONIST

Question 23

Acts centrally , as well as peripherally, by
depleting catecholamine stores in the brain
and in the peripheral adrenergic system

Answer 23

RESERPINE

Question 24

Usual dose is 0.1 to 0.25mg per day

Answer 24

RESERPINE

Question 25

Second line agents in patients with refractory to initial therapy

Answer 25

VASODILATORS

Question 26

arteriole relaxation & decrease of systemic vascular resistance

Answer 26

HYDRALAZINE

Question 27

decreases peripheral resistance

Answer 27

MINOXIDIL

Question 28

releases nitric oxide

Answer 28

NITROPRUSSIDE

Question 29

directly inhibits renin = reduction of production of Angiotensin 2

Answer 29

ALISKIREN (RENIN INHIBITOR)