Hypertension and Heart Failure Flashcards
What are the causes of hypertension?
Primary: without any single evident cause
Secondary: identifiable underlying cause
What is the 1st line pharmacological therapy for hypertension?
ACE inhibitors / Angiotensin Receptor Blockers
Calcium channel blockers
Diuretics
What are examples of ACE inhibitors?
Lisinopril, Ramipril
How do ACE inhibitors work?
Reduction in angiotensin 2 formation
Arteriolar vasodilation
Reduces aldosterone which reduces salt reabsorption in nephron
What are ADRs of ACE inhibitors?
Dry cough
Angio-oedema
Renal failure
Hyperkalaemia
How do Angiotensin receptor blockers work?
Bind to Angiotensin AT1 receptor
Inhibit vasoconstriction and aldosterone stimulation
How do Calcium channel blockers work?
Bind to alpha sub-units of L-type calcium channel reducing cellular calcium entry
Vasodilates peripheral, coronary and pulmonary arteries
What are the three main groups of calcium channel blockers?
Dihydropyridines
Phenylalkamines
Benzothiazepines
What are the ADRs of Dihydropyridines?
Sympathetic nervous activation (tachycardia and palpitations)
Flushing
Sweating
Oedema
What are the actions of Phenylalkamines?
Prolongs action potential/ effective refractory period
Peripheral vasodilation
Reduction in cardiac preload and myocardial contractility
What are the ADRs of Phenylalkamines?
Constipation
Bradycardia
Decreased myocardial contractility can actually worsen heart failure
What are the ADRs of Benzothiazepines?
Bradycardia
Can worsen heart failure
How do alpha blockers work?
Selective antagonism at post synaptic alpha1 Adrenoceptors
Reduce peripheral vascular resistance
What are the ADRs of alpha blockers?
Postural hypotension
Dizziness
Headache and fatigue
Oedema
What are the ADRs of Beta Blockers?
Lethargy
Decreased exercise tolerance
Bradycardia, cold hands
