Hypertension and Heart Failure Flashcards
how is blood pressure normally regulated
RAAS, autonomic NS, bradykinin, nitric oxide and natriuretic peptides
what is primary hypertension
where there is no single cause for the high bp
what is secondary hypertension
where there is a high bp due to an underlying cause
give some causes of secondary hypertension
Conn’s syndrome, primary hyperaldosteronism, renal artery stenosis
what non-pharmacological treatment is there for hypertension
reduced salt intake, exercise, diet, stop smoking, reduce alcohol intake
what pharmacological treatment is there for hypertension
A - ACE inhibitor or ARB
C- calcium channel blocker
D - thiazide diuretic
when would you give a calcium channel blocker first for hypertension treatment
if the patient is over 55 or black
what calcium channel blockers would you not give to treat hypertension if the patient also has heart failure
verapamil and dilitazem
which calcium channel blocker would you give to treat hypertension if the patient also has heart failure
amlodipine
how do ACE inhibitors help hypertension
reduction in aldosterone, less vasoconstriction and less water and salt retention
what does aldosterone do
inserts more ENaC and increases the speed of Na/K/ATPase
what are the side effects of ACE-I
dry cough, angio-oedema, renal failure, hypotension and hyperkalaemia
why do you get a dry cough when using ACE-I
due to the build up of bradykinin
give an example of an ACE-I
ramipril
how do angiotensin receptor blockers work
by blocking the angiotensin 2 receptor they prevent the effects of RAAS including vasoconstriction and salt/water retention
why don’t you get a dry cough when using ARBs
as the ACE can break down bradykinin so theres no build up
what do calcium channel blockers do
vasodilation
what type of diuretic should be used in hypertension
thiazide
if the ACD system doesn’t help to control the hypertension what other treatments could be used
other diuretics e.g. spironolactone
alpha blockers
beta blocker
renin inhibitor
what are the causes of heart failure
ischaemic heart disease, hypertension, valve disease, cardiomyopathy
what are the pharmacological treatments for heart failure
- ACE inhibitor
- Beta blocker
- Loop Diuretic
what type of diuretic used for heart failure
loop diuretic
why are beta blockers used for heart failure
they reduce the heart rate and lower the blood pressure decreasing the workload of the heart and so the oxygen demand of the heart
what additional drugs may be used to treat heart failure
spironolactone
digoxin
statins
