Hypertension (General)

Question 1

How is arterial pressure calculated

Answer 1

Determined by Cardiac Output and Peripheral Resistance

Pressure = Flow x Resistance

Question 2

Essential Hypertension

Answer 2

No obvious cause
- Most common
- Genetic / Environmental contributes

Question 3

Secondary Hypertension

Answer 3

Identifiable and correctable cause of hypertension

Much less common

Question 4

What organ regulates blood pressure

Answer 4

Kidneys

Question 5

Persistently High BP can cause?

Answer 5

Left Ventricular Hypertrophy (Gets bigger)

Remodeling of resistance arterioles

Predisposition to atherosclerosis

Increase risk of coronary thrombosis, stroke, renal failure

Question 6

Antihypertensive Treatment starts with what?

Answer 6

RAS Inhibitor (Young / White Person)
Thiazide Diuretic / Ca2+ Inhibitor (Older / African Person)

Question 7

If Antihypertensive Treatment does not help meet target BP what should be done

Answer 7

Add another class of drug, do not increase dose

Question 8

Captopril Mechanism of Action

Answer 8

Inhibits ACE, preventing ANG II generation
–> Lowers BP

Question 9

Captopril Adverse Effects

Answer 9

Hypotension
Cough
Taste Disturbance

Do not take if pregnant

Question 10

Valsartan Mechanism of Action

Answer 10

Inhibits AT1-Receptors on Vascular Smooth Muscle Cells
–> Prevents action of Ang II

Question 11

Valsartan Adverse Effects

Answer 11

Hypotension
Reversible Renal Impairment

Do not take if pregnant

Question 12

Bendroflumethiazide Mechanism of Action

Answer 12

Bind and inhibit distal tubule Na+/Cl- cotransporter
- Decreases reabsorption of Sodium and Chloride
- Increased excretion of sodium, chloride, and water –> Urinate a lot
–> Decrease Blood Volume –> Decrease BP

Question 13

Dihydropyridine Class

Answer 13

L-Type Voltage Gated Channel Antagonists

Mainly effect selective smooth muscle cells, treat hypertension

Question 14

Dihydropyridine Mechanism of Action

Answer 14

Reduces Ca2+ entry intro SMC
Causes generalized arterial/arteriole dilation

–> Reduces BP

Question 15

Dihydropyridine Adverse Side Effects

Answer 15

Flushing
Headache
Ankle Swelling

Question 16

Prazosin Mechanism of Action

Answer 16

Blocks NE action on vascular smooth muscle cell
- Vasodilation and Fall in Arterial Pressure
–> Reduce BP

Question 17

Prazosin Adverse Side Effect

Answer 17

Postural Hypotension
Stress Incontinence (Urinate Involuntary)
Impotence

Question 18

Beta-Adrenoceptor Antagonists Mechanism of Action

Answer 18

Reduces Cardiac Output
Reduce Renin Release from Kidney
Reduce Sympathetic Activity Centrally
–> Reduction in BP takes a few days

Question 19

Beta-Adrenoceptor Antagonists Adverse Effects

Answer 19

Bronchoconstriction
Cold Extremities
Fatigue
Cardiac Depression

Question 20

Nitroprusside
- Treats what?
- How is it used?

Answer 20

Treats hypertensive emergencies
- Short Half-Life
- Requires continuous infusion and BP monitoring
- Very Powerful Vasodilator

Question 21

Nitroprusside Mechanism of Action

Answer 21

NO Donor
- Stimulates cGMP signalling

Acts on both arterial and venous smooth muscles

Question 22

Nitroprusside Adverse Effects

Answer 22

Generates cyanide
Weakness
Nausea
Inhibition of Thyroid Function

Only use short term (72 hours max)