therapeutic control of blood pressure Flashcards
what is hypertension
clinical blood pressure = 140/90mmHg
affects 29% of adults in scotland (1.3 million people)
around 50% of myocardial infarctions and strokes are linked with hypertension
what are the therapeutic targets of hypertension
angiotensin-converting enzyme inhibitor (ACEi)
angiotensin II receptor blocker (ARB)
calcium channel blocker (CCB)
thiazide-like diuretic
what happens under normal ACE conditions
ACE in the lungs convert angiotensins I into angiotensin II resulting in an increase in circulating blood volume and increase in blood pressure
what happens under conditions where ACEi is present
ACEi blocks ACE in the lungs from converting angiotensin I to angiotensin II resulting in a decrease in circulating blood volume and a decrease in blood pressure
when would an ACEi be used
first line treatment in hypertension with type two diabetes and without type 2 diabetes but over 55 years of age and not of a black African or African-Caribbean family origin
what happens under normal angiotensin II receptor conditions
angiotensin II causes increased veno- and atrioconstriction and an increase in blood pressure
what happens under conditions where ARB is present
blocking of angiotensin II causes a decrease in veno- and atrioconstriction and a decrease in blood pressure
when would an ARB be used
first line treatment in hypertension with type two diabetes and without type 2 diabetes but over 55 years of age and not of a black African or African-Caribbean family origin
what is the emerging treatment of hypertension (zilebersiren)
investigational RNA interference therapeutic agent to inhibit synthesis of angiotensinogen
phase 1 multicentre in the UK aimed to assess safety and efficacy - single subcutaneous dose
what are the results of the zilebersiren study
dose-dependent reduction in serum angiotensinogen levels
dose-dependent reduction in both systolic and diastolic blood pressures sustained for 24 weeks
a high salt diet attenuated the benefits
