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Drugs And Disease B > Treatment Of Hypertesion > Flashcards

Treatment Of Hypertesion Flashcards

1
Q

What is hypertension?

A

A condition characterized by blood pressure readings of 140/90 mmHg or higher.

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2
Q

Why is it important to treat hypertension?

A

To prevent cardiovascular diseases and complications such as stroke, heart attack, and kidney damage.

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3
Q

What is the normal blood pressure range?

A

Systolic <120 mmHg and Diastolic <80 mmHg.

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4
Q

What are the stages of hypertension?

A
  • Pre-hypertension: 120-129/80
  • Stage 1: 130-139/80-89
  • Stage 2: 140-180/90-120
  • Hypertensive crisis: >180/>120.
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5
Q

What are common risk factors for primary hypertension?

A
  • Ageing
  • Obesity
  • High salt diet
  • Lack of exercise
  • Family history
  • Smoking
  • Drinking.
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6
Q

What is primary hypertension?

A

Hypertension with no apparent cause, affecting 90-95% of cases.

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7
Q

What is secondary hypertension?

A

Hypertension caused by underlying conditions such as chronic kidney disease or diabetes.

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8
Q

How many adults worldwide have hypertension according to WHO?

A

Approximately 1.28 billion adults aged 30-79.

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9
Q

What is the significance of hypertension being termed a ‘silent killer’?

A

About 46% of adults with hypertension are unaware of their condition.

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10
Q

What are the consequences of high blood pressure on the body?

A
  • Cardiac damage
  • Stroke
  • Kidney damage
  • Blurred/loss of vision.
  • Heart attack.
  • Heart failure.
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11
Q

What is the formula for blood pressure regulation?

A

BP = Cardiac Output (CO) x Total Peripheral Resistance (TPR).

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12
Q

What role do baroreceptors play in blood pressure regulation?

A

They sense changes in blood pressure and adjust vascular resistance or cardiac output to maintain homeostasis.

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13
Q

What is the Renin Angiotensin Aldosterone System (RAAS)?

A

A hormone system that regulates blood pressure and fluid balance.

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14
Q

What dietary approaches are recommended to stop hypertension?

A
  • DASH diet
  • Mediterranean diet.
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15
Q

What are the first-line pharmacological treatments for hypertension?

A
  • ACE inhibitors
  • Angiotensin II blockers
  • Calcium channel blockers
  • Diuretics.
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16
Q

What is the action of ACE inhibitors?

A

They block the angiotensin converting enzyme, decreasing TPR and blood pressure.

17
Q

What are common side effects of ACE inhibitors?

A
  • Hyperkalaemia
  • Cough
  • Angioedema.
18
Q

What is the purpose of Angiotensin II receptor blockers (ARBs)?

A

To block the action of Angiotensin II, lowering blood pressure.

19
Q

What are diuretics used for in hypertension treatment?

A

To promote diuresis and natriuresis, reducing blood volume and blood pressure.

20
Q

What are the major side effects of diuretics?

A
  • Hypokalaemia
  • Hyponatraemia.
21
Q

What is the mechanism of action of beta blockers?

A

They block beta-adrenergic receptors, reducing heart rate and cardiac output.

22
Q

True or False: Beta blockers are effective in reducing cardiovascular events.

A

False, they are not as effective as other first-line antihypertensives.

23
Q

What are common adverse effects of alpha blockers?

A
  • Orthostatic hypotension
  • Ankle oedema
  • Drowsiness.
24
Q

Fill in the blank: The leading contributor to all-cause mortality and disability worldwide is _______.

A

[hypertension]

25
Q

What are alpha blockers and their primary mechanism of action?

A

Alpha blockers are medications that block α1-receptors on vascular smooth muscle cells, causing vasodilatation and a decrease in total peripheral resistance (TPR) and blood pressure.

They are mainly used in combination with other anti-hypertensive agents and are considered 4th line drugs.

26
Q

What are the common adverse effects of alpha blockers?

A

Adverse effects include:
* Orthostatic hypotension
* Ankle oedema
* Drowsiness

Particularly significant on first dosing.

27
Q

In which conditions are alpha blockers indicated?

A

Alpha blockers are indicated in:
* Hyperlipidaemia
* Benign prostatic hyperplasia

They are contraindicated in mild heart failure and pre-existing orthostatic hypotension.

28
Q

What is the role of renin inhibitors in hypertension treatment?

A

Renin inhibitors block the activity of renin, inhibiting the production of Ang I from angiotensinogen and decreasing Ang II levels, which promotes vasodilation and reduces blood pressure.

Aliskiren is the only renin inhibitor.

29
Q

What are the adverse effects of renin inhibitors?

A

Adverse effects include:
* Angioedema
* Hyperkalaemia
* Headache
* Cough

They are contraindicated in pregnancy and diabetes.

30
Q

What is the RAAS and its components?

A

RAAS stands for Renin Angiotensin Aldosterone System, which includes:
* Renin
* Angiotensin I (Ang I)
* Angiotensinogen
* Angiotensin II (Ang II)
* ACE
* Aldosterone
* Vasoconstriction
* ADH
* Na+ reabsorption
* Water reabsorption

It plays a critical role in blood pressure regulation.

31
Q

What is the function of mineralocorticoid receptor antagonists?

A

Mineralocorticoid receptor antagonists block the action of aldosterone, decreasing sodium reabsorption, causing natriuresis, and reducing blood volume and blood pressure.

Examples include spironolactone, eplerenone, and finerenone.

32
Q

What defines resistant hypertension?

A

Resistant hypertension is defined as blood pressure persisting over 140/90 mmHg despite the use of 3 or more first-line anti-hypertensive medications at maximum tolerated doses.

Secondary hypertension must be ruled out.

33
Q

What is the most common reason for resistant hypertension?

A

The most common reason for resistant hypertension is poor adherence to prescribed medications.

Spironolactone is the most effective 4th medication for treating resistant hypertension.

34
Q

What therapies are used in severe resistant hypertension?

A

Therapies used in severe resistant hypertension include:
* Transcatheter renal denervation
* Baroreflex activation therapy

These treatments are utilized in some countries.

35
Q

True or False: Alpha blockers are first-line medications for treating hypertension.

A

False

They are considered 4th line drugs.

36
Q

Fill in the blank: Spironolactone is especially effective in treating _______.

A

resistant hypertension

It is more effective than alpha or beta blockers.

37
Q

What are the learning outcomes expected from the lecture on hypertension?

A

Learning outcomes include:
* Describe hypertension and its importance
* Explain why hypertension is a main risk factor for cardiovascular diseases
* Describe how blood pressure is regulated
* Explain different classes of drugs available for hypertension treatment

These outcomes aim to improve understanding and management of hypertension.

Drugs And Disease B (2 decks)

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