Pharmacology of Antihypertensive medication

Question 1

what are the goals of antihypertensive treatments?

Answer 1

1. reduce systolic pressure to <140mmHg

2. reduce diastolic pressure to <85mmHg (<80mmHg for diabetics)

Question 2

what drugs are used to treat hypertension?

Answer 2

1. Angiotensin Converting Enzyme Inhibitors (ACE inhibitors)
2. Angiotensin II receptor antagonists/ blockers (ARBs)
3. Alpha-blockers
4. Beta-blockers
5. Calcium channel blockers (CCBs)
6. Diuretics (Thiazide)

Question 3

what drugs are more effective on elderlies?

Answer 3

Thiazides (diuretics)

Question 4

what drugs are least effective on elderlies?

Answer 4

betablockers

Question 5

what drugs are least effective on black people?

Answer 5

ACE inhibitors

Question 6

what are AB drugs and what do they do?

Answer 6

• AB drugs are ACE inhibitors, ARBs (Angiotensin II receptor antagonists/ blockers) and Betablockers
• they inhibit the renin-angiotensin system

Question 7

what are CD drugs and what do they do?

Answer 7

• Calcium channel blockers and Diuretics (thiazides)

- reduce peripheral resistance

Question 8

what drug is started with to treat hypertension in young patients (<55yrs)

Answer 8

ACE inhibitors

Question 9

what drug is started with to treat hypertension in older patients (>55yrs) or in Afro-Caribbean patients?

Answer 9

Calcium Channel Blockers

Question 10

during combination therapy, what three drugs are commonly combined?

Answer 10

ACE inhibitors (or ARBs), Calcium channel blockers and Diuretics

Question 11

why might treatment fail?

Answer 11

1. lifestyle (alcohol, exercise, diet)
2. Ineffective prescription dose & compliance
3. volume overload (renal problems)
4. unsuspected secondary cause