HYPERTENSION Flashcards
blood pressure is elevated enough to perfuse tissues and organs
HYPERTENSION
What are the Classification of Hypertension
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
Incidence:
PRIMARY HYPERTENSION
SECONDARY HYPERTENSION
Physiology:
Blood Pressure = CO (Cardiac Output) x TPR ( Total Peripheral Resistance)
Formula for Cardiac Output
SV ( Stroke Volume) x HR ( Heart Rate)
Complications:
1.) Cardiac Effects
a.) Left ventricular Hypertrophy
b.) Accelerated Atherosclerosis
2.) Renal Effects
3.) Cerebral Effects
4.) Retinal Effects
PREDISPOSING FACTORS
- Family history
- Patient history
- Racial predisposition
- Obesity
- Smoking
- Stress
- Sedentary lifestyle
- Intake of fats and salts
Patient’s history and other physical findings suggest an underlying cause of hypertension
Secondary Hypertension
DIAGNOSTICS
CBC
Lipid Profile
UA (HDL, LDL, Triglycerides)
SGOT
SGPT
Na
K
Ca
BUN
BUA
FBS & RBS
CREA
HBA1C
General Principle:
to lower blood pressure toward NORMAL with minimal side effects and to prevent or reverse organ damage
Candidates for Treatment:
Patients with diastolic >90 mmhg and systolic of >140 mmhg
MOA: inhibition of the conversion of angiotensin 1 to angiotensin 2
ACE INHIBITORS
ACE INHIBITORS examples
Captopril, enalaparil (enalaprilat), fosinopril,
lisinopril, dolapril, perindopril, etc.
MOA: works by blocking the binding of
Angiotensin 2 to the receptor
ANGIOTENSIN RECEPTOR BLOCKERS
ANGIOTENSIN RECEPTOR BLOCKERS examples
Telmisartan, Losartan, olmesartan, valsartan, etc.
MOA: Blocks Beta adrenergic system
BETA BLOCKERS
Whites with high cardiac output, high heart rate and normal vascular resistance
respond the best with beta blockers
BETA BLOCKERS
Beta blockers must be used cautiously in patients with
DM, Reynaud’s syndrome & Neurological
Disorder
MOA: Inhibits influx of calcium through slow channels in vascular smooth muscle and cause relaxation
CALCIUM CHANNEL BLOCKERS
These agents must be used with extreme caution or not at all in patient with conductive disturbances involving SA and AV node.
NON - DIHYDROPYRIDINE
MOA: blocks the peripheral postsynaptic Alpha-1 adrenergic receptor.
PERIPHERAL ALPHA -1 ADRENERGIC
ANTAGONIST
Given to HTN patients who have not responded to initial HTN therapy.
PERIPHERAL ALPHA -1 ADRENERGIC
ANTAGONIST
MOA: act primarily within the CNS on alpha 2 receptors to decrease sympathetic outflow to the cardiovascular system
CENTRALLY ACTIVE ALPHA AGONIST
Acts centrally , as well as peripherally, by
depleting catecholamine stores in the brain
and in the peripheral adrenergic system
RESERPINE
