This document provides information on hypertension including its definition, etiology, signs and symptoms, classification, treatment and treatment guidelines. It defines hypertension as a condition where blood pressure is chronically elevated above 140/90 mmHg. The causes of hypertension are categorized as primary (essential) or secondary. Treatment involves non-pharmacological methods as well as various classes of antihypertensive drugs like ACE inhibitors, ARBs, calcium channel blockers, beta blockers, diuretics and vasodilators. The guidelines recommend starting treatment with one drug and adding a second from a different class if target is not reached after 3 months. Drug combinations should be used carefully due to risk of interactions.
Essential hypertension management and treatmentFabio Grubba
This document discusses hypertension (high blood pressure), including its classification, causes, symptoms, diagnosis, and treatment. It defines the different stages of hypertension according to blood pressure readings. Lifestyle modifications are recommended initially, including diet changes and exercise. If lifestyle changes do not control blood pressure, medications such as diuretics, beta-blockers, calcium channel blockers, ACE inhibitors, and other drug classes may be used. The goal of treatment is to prevent complications in target organs like the heart, brain, and kidneys by maintaining a blood pressure below 140/90 mmHg.
This document discusses the principles of drug therapy for hypertension. It defines hypertension and outlines the risks of not treating it. The main types of hypertension are essential and secondary hypertension. Lifestyle factors like stress, sodium intake, obesity, and smoking can increase risk. The JNC 7 and 8 guidelines classify and recommend treatment for various blood pressure levels. The renal, baroreceptor, and renin-angiotensin systems help regulate blood pressure. Most antihypertensive drugs act by interfering with these normal mechanisms. Initial treatment typically involves a single drug, with combination therapy used if targets are not met. Drug selection depends on individual patient factors and comorbidities.
This document discusses hypertension (high blood pressure) including its definition, causes, clinical presentation, assessment, and management. It notes that hypertension is defined as blood pressure above 140/90 mmHg and risks of cardiovascular disease double for every 20/10 mmHg rise. Common complications include stroke, myocardial infarction, heart failure, and renal failure. Treatment involves lifestyle modifications and medication, starting with ACE inhibitors, calcium channel blockers, or thiazides. The goals are to lower blood pressure and reduce cardiovascular risk based on individual patient factors.
Hypertension, or high blood pressure, affects nearly 1 billion people worldwide. It is a leading cause of death and is poorly controlled in many countries. May 14th is recognized as World Hypertension Day to increase awareness. Hypertension is defined as a systolic blood pressure over 140 mmHg or a diastolic over 90 mmHg. Lifestyle modifications like weight loss, dietary changes, and increased physical activity can help control blood pressure but medication is often required. Treatment goals are to reduce blood pressure below 140/90 mmHg or 130/80 for those with diabetes or kidney disease to lower the risks of complications.
Hypertension, or high blood pressure, is classified as either primary (essential) or secondary. Primary hypertension accounts for 90% of cases and has no identifiable cause, while secondary hypertension is caused by an underlying condition like renal disease. Treatment involves lifestyle modifications and medication, with thiazide diuretics often used as initial therapy. Other common drug classes for treatment include ACE inhibitors, calcium channel blockers, beta blockers, and alpha blockers. Multiple drug therapy is usually required to control hypertension.
The document discusses guidelines for treating hypertension, including:
1) Lifestyle modifications and drug therapy are recommended to reduce hypertension-related organ damage and mortality. Primary drug classes include diuretics, ACE inhibitors, ARBs, beta-blockers, and calcium channel blockers.
2) Treatment approaches vary for specific conditions like heart failure, heart attack, diabetes, and kidney disease. For example, ACE inhibitors plus diuretics and beta-blockers are recommended for heart failure.
3) Drug selection depends on other factors like age, risk of side effects, and concomitant diseases or conditions. Combination drug therapy is often needed to control blood pressure.
Hypertension, also known as high blood pressure, is a major public health problem worldwide. It is a chronic medical condition in which the blood pressure in the arteries is persistently elevated. While there is no cure, lifestyle modifications and medication can help prevent and manage hypertension. The goal of treatment is to reduce cardiovascular and renal risks and complications through lowering blood pressure. Treatment typically involves a combination of lifestyle changes and medications, with regular monitoring needed to control the condition.
Hypertension is also known as high blood pressure. There are mainly two type of blood pressure i.e. systolic and another one is diastolic . The hypertension are categories into two parts that is primary hypertension and secondary hypertension. People are suffering from 3 stage during the condition of hypertension. There are following agents are used to treat hypertension like calcium channel blockers, ACE inhibitors, beta blocker, alpha + beta blockers these are commonly used.
Essential hypertension management and treatmentFabio Grubba
This document discusses hypertension (high blood pressure), including its classification, causes, symptoms, diagnosis, and treatment. It defines the different stages of hypertension according to blood pressure readings. Lifestyle modifications are recommended initially, including diet changes and exercise. If lifestyle changes do not control blood pressure, medications such as diuretics, beta-blockers, calcium channel blockers, ACE inhibitors, and other drug classes may be used. The goal of treatment is to prevent complications in target organs like the heart, brain, and kidneys by maintaining a blood pressure below 140/90 mmHg.
This document discusses the principles of drug therapy for hypertension. It defines hypertension and outlines the risks of not treating it. The main types of hypertension are essential and secondary hypertension. Lifestyle factors like stress, sodium intake, obesity, and smoking can increase risk. The JNC 7 and 8 guidelines classify and recommend treatment for various blood pressure levels. The renal, baroreceptor, and renin-angiotensin systems help regulate blood pressure. Most antihypertensive drugs act by interfering with these normal mechanisms. Initial treatment typically involves a single drug, with combination therapy used if targets are not met. Drug selection depends on individual patient factors and comorbidities.
This document discusses hypertension (high blood pressure) including its definition, causes, clinical presentation, assessment, and management. It notes that hypertension is defined as blood pressure above 140/90 mmHg and risks of cardiovascular disease double for every 20/10 mmHg rise. Common complications include stroke, myocardial infarction, heart failure, and renal failure. Treatment involves lifestyle modifications and medication, starting with ACE inhibitors, calcium channel blockers, or thiazides. The goals are to lower blood pressure and reduce cardiovascular risk based on individual patient factors.
Hypertension, or high blood pressure, affects nearly 1 billion people worldwide. It is a leading cause of death and is poorly controlled in many countries. May 14th is recognized as World Hypertension Day to increase awareness. Hypertension is defined as a systolic blood pressure over 140 mmHg or a diastolic over 90 mmHg. Lifestyle modifications like weight loss, dietary changes, and increased physical activity can help control blood pressure but medication is often required. Treatment goals are to reduce blood pressure below 140/90 mmHg or 130/80 for those with diabetes or kidney disease to lower the risks of complications.
Hypertension, or high blood pressure, is classified as either primary (essential) or secondary. Primary hypertension accounts for 90% of cases and has no identifiable cause, while secondary hypertension is caused by an underlying condition like renal disease. Treatment involves lifestyle modifications and medication, with thiazide diuretics often used as initial therapy. Other common drug classes for treatment include ACE inhibitors, calcium channel blockers, beta blockers, and alpha blockers. Multiple drug therapy is usually required to control hypertension.
The document discusses guidelines for treating hypertension, including:
1) Lifestyle modifications and drug therapy are recommended to reduce hypertension-related organ damage and mortality. Primary drug classes include diuretics, ACE inhibitors, ARBs, beta-blockers, and calcium channel blockers.
2) Treatment approaches vary for specific conditions like heart failure, heart attack, diabetes, and kidney disease. For example, ACE inhibitors plus diuretics and beta-blockers are recommended for heart failure.
3) Drug selection depends on other factors like age, risk of side effects, and concomitant diseases or conditions. Combination drug therapy is often needed to control blood pressure.
Hypertension, also known as high blood pressure, is a major public health problem worldwide. It is a chronic medical condition in which the blood pressure in the arteries is persistently elevated. While there is no cure, lifestyle modifications and medication can help prevent and manage hypertension. The goal of treatment is to reduce cardiovascular and renal risks and complications through lowering blood pressure. Treatment typically involves a combination of lifestyle changes and medications, with regular monitoring needed to control the condition.
Hypertension is also known as high blood pressure. There are mainly two type of blood pressure i.e. systolic and another one is diastolic . The hypertension are categories into two parts that is primary hypertension and secondary hypertension. People are suffering from 3 stage during the condition of hypertension. There are following agents are used to treat hypertension like calcium channel blockers, ACE inhibitors, beta blocker, alpha + beta blockers these are commonly used.
Systemic hypertension is defined as high blood pressure measured on 3 occasions. It is important to properly measure blood pressure in children using the correct cuff size based on age and arm circumference. Common causes of hypertension in children include primary hypertension, renal disease, vascular abnormalities like coarctation of the aorta, and endocrine disorders. Clinical evaluation involves taking a thorough history and physical examination to identify risk factors and look for signs of end organ damage from high blood pressure.
This document discusses hypertension, including guidelines for diagnosis, treatment, and management based on individual patient factors. It recommends measuring blood pressure in both arms using a mercury sphygmomanometer and checking for postural drops. Lifestyle modifications like maintaining a healthy BMI, reducing salt intake, moderate alcohol consumption, regular exercise, and smoking cessation are first-line treatment options. It provides guidance on when pharmacological treatment should begin based on a patient's global cardiovascular risk profile and comorbidities. It also outlines protocols for treating severe, urgent, and emergency cases of hypertension.
This document discusses hypertension and its treatment. It defines hypertension and describes its prevalence globally. It notes that only half of those with hypertension have been diagnosed, treated, and adequately controlled. It describes primary and secondary causes of hypertension. The main classes of antihypertensive medications are discussed - diuretics, beta blockers, calcium channel blockers, ACE inhibitors, and alpha blockers. Specific examples within each class are explained. The document emphasizes the goal of treatment is to reduce blood pressure below 140/90 mmHg to prevent cardiac and renal complications.
Hypertension pharmacotherapy part 2 pptPranatiChavan
First-line medications used in the treatment of hypertension include diuretics, angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs), beta-blockers, and calcium channel blockers (CCBs). Some patients will require 2 or more antihypertensive medications to achieve their BP target. As per special consideration, modified treatment is given in the presentation.
This presentation consists of various approaches to treat hypertension depending on severity. It also include treatment according to international guidelines. Classification and brief description of each antihypertensive agent has been mentioned.
Phamacological Management of Essential Hypertension - Revision Guidemeducationdotnet
This document provides a summary of the pharmacological management of essential hypertension. It discusses various drug classes used to treat hypertension including ACE inhibitors, ARBs, calcium channel blockers, diuretics, beta blockers, and others. For each drug class, it summarizes the mechanism of action, examples of drugs, uses, cautions/contraindications, and side effects. It emphasizes that lifestyle changes should be discussed before starting pharmacological treatment and drugs may be combined if single drug treatment does not achieve blood pressure targets. The document aims to provide an easy to understand format for key points useful in a clinical situation.
High blood pressure, or hypertension, is defined as blood pressure above 140/90 mmHg and affects around 50 million people in the US. It occurs when the force of blood against artery walls is too high and can lead to heart disease and stroke over time if not managed. Hypertension is primarily diagnosed through repeated blood pressure readings and treated initially through lifestyle changes like diet, exercise, and reducing stress and alcohol/tobacco use. If lifestyle changes are insufficient, medication therapy is used, which may include ACE inhibitors, ARBs, calcium channel blockers, diuretics, beta blockers, and alpha blockers to help relax blood vessels and lower blood pressure.
Epidemiology , diagnosis and treatment of Hypertension Toufiqur Rahman
Hypertension, Blood pressure, Systolic Hypertension, Diastolic Hypertension, Epidemiology, Classification of hypertention, Type of hypertension, aetiology of hypertension, Clinical features, complications of hypertension, ambulatory blood pressure monitoring, Resistant hypertension, anti hypertensives,
This document provides an overview of hypertension for pharmacotherapy students. It defines hypertension and classifies blood pressure levels. It discusses the underlying causes, risk factors, symptoms, complications, goals of treatment, and appropriate evaluation. It also describes the major classes of antihypertensive drugs including ACE inhibitors, ARBs, calcium channel blockers, thiazide diuretics, and beta blockers. Treatment approaches are outlined based on clinical guidelines. The document is intended to help students understand the diagnosis and management of hypertension.
Drugs used in treatment of HypertensionAluru Revathi
This document provides an overview of drugs used to treat hypertension. It defines hypertension and outlines its causes, complications, stages, types and diagnosis. It discusses JNC guidelines and the regulation of blood pressure. The document focuses on the management of hypertension through non-pharmacological approaches and various drug therapies, describing the mechanisms and examples of different drug classes including ACE inhibitors, calcium channel blockers, diuretics, alpha-blockers, beta-blockers, and vasodilators. It also addresses treatment of hypertensive emergencies and drugs to avoid or that are safe in pregnancy.
This document provides an overview of hypertension including its classification, types, signs and symptoms, causes, and treatment. It defines hypertension as having a systolic blood pressure over 140 mmHg or a diastolic blood pressure over 90 mmHg. The document classifies hypertension and discusses the types of essential and secondary hypertension. It outlines the signs and symptoms of hypertension and discusses its causes. The document then describes the classification and mechanisms of antihypertensive drugs and provides details on drug classes including diuretics, ACE inhibitors, calcium channel blockers, and others. It discusses treatment approaches for hypertension and managing hypertensive emergencies.
Hypertension, or high blood pressure, refers to blood pressure above 140/90 mmHg. It puts stress on blood vessels and vital organs like the heart, brain, and kidneys over time if not controlled. The document discusses what causes hypertension, risk factors, potential health effects, diagnosis through blood pressure monitoring, treatment through lifestyle modifications and medications, and treatment goals of lowering blood pressure to reduce risks of heart disease, stroke, and other complications. Treatment involves lifestyle changes like losing weight, reducing salt, exercising, and quitting smoking, as well as medications like diuretics, beta-blockers, calcium channel blockers, ACE inhibitors, and ARBs.
This document provides an overview of essential hypertension including its definition, classifications, causes, detection, importance, prevention, management, goals of treatment, classes of drugs and their side effects, and specific management for patients with ischemic heart disease or diabetes. Essential hypertension is high blood pressure where secondary causes are not identified, accounts for 95% of hypertension cases, and needs to be further classified. Lifestyle modifications and pharmacologic treatments can help control blood pressure to reduce health risks.
Hypertension, or high blood pressure, is defined as a systolic blood pressure of 140 mm Hg or higher or a diastolic blood pressure of 90 mm Hg or higher. Factors that influence blood pressure include heart rate, sympathetic nervous system activity, vasoconstriction/vasodilation, and fluid volume regulated by the renin-angiotensin and aldosterone systems. Lifestyle modifications such as weight loss, following the DASH diet, reducing sodium intake, limiting alcohol, and regular exercise are first-line treatment recommendations for controlling hypertension before starting drug therapy.
1) The document defines hypertension and provides its classification and diagnostic criteria. It discusses non-pharmacological and pharmacological treatment options.
2) Specific treatment recommendations are provided for different hypertensive patient groups including those with diabetes, chronic kidney disease, heart disease and the elderly.
3) Treatment of hypertensive emergencies and crises is covered, along with definitions of resistant and refractory hypertension. Device-based renal denervation therapy is mentioned briefly.
Blood pressure is a measurement of the force against artery walls as the heart pumps blood. Normal blood pressure is under 120/80 mmHg, while readings over that are considered high. High blood pressure can damage organs if left untreated over time. Lifestyle changes like diet, exercise, weight control, and limiting alcohol can help control high blood pressure, as can medications like diuretics, beta-blockers, ACE inhibitors, calcium channel blockers, and alpha-blockers.
Hypertension, or high blood pressure, is defined as blood pressure above 140/90 mmHg. It can be classified into stages based on systolic and diastolic blood pressure readings. The majority of cases are primary or essential hypertension, while a small percentage are secondary to other conditions. Target organ damage to the heart, brain, kidneys and eyes can occur if hypertension is not controlled. Lifestyle modifications and medications are used to treat and manage hypertension. Nursing care involves educating patients, monitoring for complications, and promoting treatment adherence.
This document discusses antihypertensive drugs used to treat hypertension, defined as a systolic blood pressure of 140 mmHg or higher and/or diastolic blood pressure of 90 mmHg or higher. It describes the mechanisms that normally regulate blood pressure and how hypertension disrupts these mechanisms. It then categorizes and describes several classes of antihypertensive drugs, including ACE inhibitors, angiotensin receptor blockers, calcium channel blockers, diuretics, beta blockers, and others. Specifically, it focuses on ACE inhibitors, explaining how they work by inhibiting the angiotensin-converting enzyme and the renin-angiotensin-aldosterone system to lower blood pressure and their
This document summarizes the chemistry of antihypertensive agents. It begins by defining hypertension as high blood pressure that can be caused by both environmental and genetic factors. It then classifies antihypertensive drugs into four main categories: 1) sympatholytic drugs that act on adrenergic receptors, 2) vasodilators such as nitric oxide releasers and calcium channel blockers, 3) diuretics including thiazides and loop diuretics, and 4) angiotensin inhibitors and antagonists like ACE inhibitors and angiotensin receptor blockers. Examples of specific drugs are discussed within each class, along with their mechanisms of action and brief descriptions of relevant syntheses.
Hypertension, or high blood pressure, is a major global health issue. It is defined as a systolic blood pressure over 140 mmHg or a diastolic over 90 mmHg. Risk factors include age, family history, stress, obesity, alcohol, sodium intake and lack of exercise. Complications can include heart disease, stroke, kidney disease and eye damage if left untreated. Treatment involves lifestyle changes like diet, exercise and weight loss as well as medications that lower blood pressure such as diuretics, ACE inhibitors, calcium channel blockers and beta blockers. Nurses play an important role in educating patients about hypertension management.
Systemic hypertension is defined as high blood pressure measured on 3 occasions. It is important to properly measure blood pressure in children using the correct cuff size based on age and arm circumference. Common causes of hypertension in children include primary hypertension, renal disease, vascular abnormalities like coarctation of the aorta, and endocrine disorders. Clinical evaluation involves taking a thorough history and physical examination to identify risk factors and look for signs of end organ damage from high blood pressure.
This document discusses hypertension, including guidelines for diagnosis, treatment, and management based on individual patient factors. It recommends measuring blood pressure in both arms using a mercury sphygmomanometer and checking for postural drops. Lifestyle modifications like maintaining a healthy BMI, reducing salt intake, moderate alcohol consumption, regular exercise, and smoking cessation are first-line treatment options. It provides guidance on when pharmacological treatment should begin based on a patient's global cardiovascular risk profile and comorbidities. It also outlines protocols for treating severe, urgent, and emergency cases of hypertension.
This document discusses hypertension and its treatment. It defines hypertension and describes its prevalence globally. It notes that only half of those with hypertension have been diagnosed, treated, and adequately controlled. It describes primary and secondary causes of hypertension. The main classes of antihypertensive medications are discussed - diuretics, beta blockers, calcium channel blockers, ACE inhibitors, and alpha blockers. Specific examples within each class are explained. The document emphasizes the goal of treatment is to reduce blood pressure below 140/90 mmHg to prevent cardiac and renal complications.
Hypertension pharmacotherapy part 2 pptPranatiChavan
First-line medications used in the treatment of hypertension include diuretics, angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs), beta-blockers, and calcium channel blockers (CCBs). Some patients will require 2 or more antihypertensive medications to achieve their BP target. As per special consideration, modified treatment is given in the presentation.
This presentation consists of various approaches to treat hypertension depending on severity. It also include treatment according to international guidelines. Classification and brief description of each antihypertensive agent has been mentioned.
Phamacological Management of Essential Hypertension - Revision Guidemeducationdotnet
This document provides a summary of the pharmacological management of essential hypertension. It discusses various drug classes used to treat hypertension including ACE inhibitors, ARBs, calcium channel blockers, diuretics, beta blockers, and others. For each drug class, it summarizes the mechanism of action, examples of drugs, uses, cautions/contraindications, and side effects. It emphasizes that lifestyle changes should be discussed before starting pharmacological treatment and drugs may be combined if single drug treatment does not achieve blood pressure targets. The document aims to provide an easy to understand format for key points useful in a clinical situation.
High blood pressure, or hypertension, is defined as blood pressure above 140/90 mmHg and affects around 50 million people in the US. It occurs when the force of blood against artery walls is too high and can lead to heart disease and stroke over time if not managed. Hypertension is primarily diagnosed through repeated blood pressure readings and treated initially through lifestyle changes like diet, exercise, and reducing stress and alcohol/tobacco use. If lifestyle changes are insufficient, medication therapy is used, which may include ACE inhibitors, ARBs, calcium channel blockers, diuretics, beta blockers, and alpha blockers to help relax blood vessels and lower blood pressure.
Epidemiology , diagnosis and treatment of Hypertension Toufiqur Rahman
Hypertension, Blood pressure, Systolic Hypertension, Diastolic Hypertension, Epidemiology, Classification of hypertention, Type of hypertension, aetiology of hypertension, Clinical features, complications of hypertension, ambulatory blood pressure monitoring, Resistant hypertension, anti hypertensives,
This document provides an overview of hypertension for pharmacotherapy students. It defines hypertension and classifies blood pressure levels. It discusses the underlying causes, risk factors, symptoms, complications, goals of treatment, and appropriate evaluation. It also describes the major classes of antihypertensive drugs including ACE inhibitors, ARBs, calcium channel blockers, thiazide diuretics, and beta blockers. Treatment approaches are outlined based on clinical guidelines. The document is intended to help students understand the diagnosis and management of hypertension.
Drugs used in treatment of HypertensionAluru Revathi
This document provides an overview of drugs used to treat hypertension. It defines hypertension and outlines its causes, complications, stages, types and diagnosis. It discusses JNC guidelines and the regulation of blood pressure. The document focuses on the management of hypertension through non-pharmacological approaches and various drug therapies, describing the mechanisms and examples of different drug classes including ACE inhibitors, calcium channel blockers, diuretics, alpha-blockers, beta-blockers, and vasodilators. It also addresses treatment of hypertensive emergencies and drugs to avoid or that are safe in pregnancy.
This document provides an overview of hypertension including its classification, types, signs and symptoms, causes, and treatment. It defines hypertension as having a systolic blood pressure over 140 mmHg or a diastolic blood pressure over 90 mmHg. The document classifies hypertension and discusses the types of essential and secondary hypertension. It outlines the signs and symptoms of hypertension and discusses its causes. The document then describes the classification and mechanisms of antihypertensive drugs and provides details on drug classes including diuretics, ACE inhibitors, calcium channel blockers, and others. It discusses treatment approaches for hypertension and managing hypertensive emergencies.
Hypertension, or high blood pressure, refers to blood pressure above 140/90 mmHg. It puts stress on blood vessels and vital organs like the heart, brain, and kidneys over time if not controlled. The document discusses what causes hypertension, risk factors, potential health effects, diagnosis through blood pressure monitoring, treatment through lifestyle modifications and medications, and treatment goals of lowering blood pressure to reduce risks of heart disease, stroke, and other complications. Treatment involves lifestyle changes like losing weight, reducing salt, exercising, and quitting smoking, as well as medications like diuretics, beta-blockers, calcium channel blockers, ACE inhibitors, and ARBs.
This document provides an overview of essential hypertension including its definition, classifications, causes, detection, importance, prevention, management, goals of treatment, classes of drugs and their side effects, and specific management for patients with ischemic heart disease or diabetes. Essential hypertension is high blood pressure where secondary causes are not identified, accounts for 95% of hypertension cases, and needs to be further classified. Lifestyle modifications and pharmacologic treatments can help control blood pressure to reduce health risks.
Hypertension, or high blood pressure, is defined as a systolic blood pressure of 140 mm Hg or higher or a diastolic blood pressure of 90 mm Hg or higher. Factors that influence blood pressure include heart rate, sympathetic nervous system activity, vasoconstriction/vasodilation, and fluid volume regulated by the renin-angiotensin and aldosterone systems. Lifestyle modifications such as weight loss, following the DASH diet, reducing sodium intake, limiting alcohol, and regular exercise are first-line treatment recommendations for controlling hypertension before starting drug therapy.
1) The document defines hypertension and provides its classification and diagnostic criteria. It discusses non-pharmacological and pharmacological treatment options.
2) Specific treatment recommendations are provided for different hypertensive patient groups including those with diabetes, chronic kidney disease, heart disease and the elderly.
3) Treatment of hypertensive emergencies and crises is covered, along with definitions of resistant and refractory hypertension. Device-based renal denervation therapy is mentioned briefly.
Blood pressure is a measurement of the force against artery walls as the heart pumps blood. Normal blood pressure is under 120/80 mmHg, while readings over that are considered high. High blood pressure can damage organs if left untreated over time. Lifestyle changes like diet, exercise, weight control, and limiting alcohol can help control high blood pressure, as can medications like diuretics, beta-blockers, ACE inhibitors, calcium channel blockers, and alpha-blockers.
Hypertension, or high blood pressure, is defined as blood pressure above 140/90 mmHg. It can be classified into stages based on systolic and diastolic blood pressure readings. The majority of cases are primary or essential hypertension, while a small percentage are secondary to other conditions. Target organ damage to the heart, brain, kidneys and eyes can occur if hypertension is not controlled. Lifestyle modifications and medications are used to treat and manage hypertension. Nursing care involves educating patients, monitoring for complications, and promoting treatment adherence.
This document discusses antihypertensive drugs used to treat hypertension, defined as a systolic blood pressure of 140 mmHg or higher and/or diastolic blood pressure of 90 mmHg or higher. It describes the mechanisms that normally regulate blood pressure and how hypertension disrupts these mechanisms. It then categorizes and describes several classes of antihypertensive drugs, including ACE inhibitors, angiotensin receptor blockers, calcium channel blockers, diuretics, beta blockers, and others. Specifically, it focuses on ACE inhibitors, explaining how they work by inhibiting the angiotensin-converting enzyme and the renin-angiotensin-aldosterone system to lower blood pressure and their
This document summarizes the chemistry of antihypertensive agents. It begins by defining hypertension as high blood pressure that can be caused by both environmental and genetic factors. It then classifies antihypertensive drugs into four main categories: 1) sympatholytic drugs that act on adrenergic receptors, 2) vasodilators such as nitric oxide releasers and calcium channel blockers, 3) diuretics including thiazides and loop diuretics, and 4) angiotensin inhibitors and antagonists like ACE inhibitors and angiotensin receptor blockers. Examples of specific drugs are discussed within each class, along with their mechanisms of action and brief descriptions of relevant syntheses.
Hypertension, or high blood pressure, is a major global health issue. It is defined as a systolic blood pressure over 140 mmHg or a diastolic over 90 mmHg. Risk factors include age, family history, stress, obesity, alcohol, sodium intake and lack of exercise. Complications can include heart disease, stroke, kidney disease and eye damage if left untreated. Treatment involves lifestyle changes like diet, exercise and weight loss as well as medications that lower blood pressure such as diuretics, ACE inhibitors, calcium channel blockers and beta blockers. Nurses play an important role in educating patients about hypertension management.
This document summarizes a seminar presentation on hypertension given by two nursing students. It began with an outline and objectives. The students then defined hypertension and discussed blood pressure classifications. They explained determinants of blood pressure and risk factors for primary hypertension. Clinical manifestations, complications, and types of hypertension such as primary, secondary, and hypertensive crisis were summarized. The students concluded by discussing diagnostic evaluation, management through lifestyle modifications and pharmacological treatments, and the stepwise algorithm for hypertension management.
Hypertension, also known as high blood pressure, is a long-term medical condition in which the blood pressure in the arteries is persistently elevated. Blood pressure is expressed using two measurements - systolic and diastolic pressures. For most adults, normal blood pressure is within the range of 100-130 mmHg systolic and 60-80 mmHg diastolic. High blood pressure is present if the resting blood pressure is persistently at or above 130/80 or 140/90 mmHg. Treatment involves lifestyle modifications and medications such as diuretics, ACE inhibitors, ARBs, calcium channel blockers, and beta blockers. Uncontrolled high blood pressure can lead to damage of vital organs and increase risk of
This document summarizes the pharmacology of medications used to treat hypertension, including ACE inhibitors, ARBs, and CCBs. It reviews their mechanisms of action, efficacy, and safety profiles. It also discusses the renin-angiotensin system and its role in hypertension, current treatment guidelines, lifestyle modifications, and algorithms for antihypertensive drug selection and combination therapy.
This document discusses hypertension (high blood pressure), including its causes, symptoms, diagnosis, and treatment. It defines hypertension and describes its classification. It also outlines lifestyle modifications and medications that are used to treat hypertension. The goals of treatment are to lower blood pressure and prevent target organ damage to the heart, brain, kidneys and eyes. Nursing care focuses on educating patients, monitoring for side effects, ensuring compliance with treatment, and evaluating treatment effectiveness.
A presentation hypertension
(what blood pressure is, what is hypertension, what are the risk factors of hypertension, how is it managed?) and other related knowledge on hypertension
Hypertension, also known as high blood pressure, is a condition characterized by consistently elevated blood pressure readings. It is measured in units of millimeters of mercury (mm Hg) and expressed as systolic and diastolic pressures. Hypertension has various stages defined by specific blood pressure thresholds and is influenced by risk factors like age, family history, obesity, diet, smoking, alcohol, and lack of exercise. Common complications include cardiovascular diseases, stroke, kidney disease, and eye problems. Treatment involves lifestyle modifications like a healthy diet, exercise, weight control, and quitting smoking as well as medications that work via different mechanisms such as diuretics, ACE inhibitors, ARBs, calcium channel blockers, and beta block
Hypertension, also known as high blood pressure, is a medical condition defined as blood pressure above 140/90 mmHg. It is often asymptomatic but can lead to serious health issues like heart disease or stroke if left untreated. Treatment involves lifestyle modifications like reducing salt intake, exercise, and weight loss. Medications may also be prescribed depending on severity, such as ACE inhibitors, calcium channel blockers, beta blockers, or diuretics. For hypertensive emergencies with very high blood pressure, intravenous drugs are used to rapidly lower the pressure.
1. Drugs Hypertesnion, heart failure and arryhthmia.pptxweldat1
This document discusses drug therapy for hypertension. It begins by defining hypertension and classifying blood pressure readings. Lifestyle modifications that can help control hypertension are described, including weight loss, reducing salt intake, moderating alcohol, and exercise. Pharmacological treatments are then outlined, with diuretics being the first-line treatment. The document focuses on different classes of diuretics including thiazides, loop diuretics, and potassium-sparing diuretics. Adverse effects of diuretics like hypokalemia are also covered.
The document provides an overview of congestive heart failure including its definition, epidemiology, etiology, types, risk factors, pathogenesis, signs and symptoms, diagnosis, management goals, and pharmacological and surgical treatment options. It discusses how heart failure results from the heart's inability to pump sufficient blood and covers compensatory mechanisms and factors that can precipitate or exacerbate the condition. Treatment focuses on improving quality of life, relieving symptoms, and slowing disease progression through lifestyle changes, medications like diuretics, ACE inhibitors, beta-blockers, and surgery in some cases.
Hypertension, or high blood pressure, is one of the most common diseases worldwide. It is a major risk factor for heart disease and stroke. The document discusses the definition, classification, evaluation, causes, treatment, and prevention of hypertension. Prevention strategies recommended by WHO include reducing salt intake, maintaining a healthy weight, regular exercise, stress reduction, not smoking, and modifying lifestyle behaviors. Treatment aims to lower blood pressure below 140/90 mmHg through lifestyle changes and lifelong medication if needed.
Hypertension, or high blood pressure, is defined based on average readings from multiple visits. It is classified by the WHO into normal, prehypertension, and stages 1 and 2 hypertension. Primary hypertension has no identifiable cause while secondary hypertension has identifiable underlying causes. Complications arise from damage to blood vessels and target organs like the brain, heart, kidneys, and eyes. Treatment involves lifestyle modifications and medications like diuretics, ACE inhibitors, calcium channel blockers, and beta-blockers. Care must be taken with anesthesia as patients can experience exaggerated blood pressure changes in response to stimuli. Antihypertensive medications should generally be continued during surgery.
This document provides an overview of hypertension including its diagnosis, management, and treatment. It defines hypertension and classifies blood pressure levels. Lifestyle factors and common causes of primary and secondary hypertension are discussed. Target organ damage from hypertension is described along with clinical manifestations. Treatment involves lifestyle modifications and medication including diuretics, beta blockers, ACE inhibitors, calcium channel blockers, and ARBs. Factors influencing medication choice and treatment failure are also summarized.
Hypertension, also known as high blood pressure, is defined as a systolic blood pressure above 140 mmHg or a diastolic blood pressure above 90 mmHg. It is a major health problem affecting over 30% of adults in the US. While most cases of hypertension have no known cause, risk factors include age, diet, physical activity levels, obesity, and family history. Left untreated, hypertension can lead to serious health complications like heart attack, stroke, kidney failure, and retinal damage. Lifestyle modifications including reduced salt intake, increased physical activity, and weight loss are recommended as first-line treatment, along with medication if needed to control blood pressure.
This document discusses various classes of antihypertensive drugs used to treat high blood pressure. It describes 7 classes: diuretics, beta blockers, calcium channel blockers, ACE inhibitors, angiotensin receptor blockers, sympatholytic and alpha adrenergic blockers, and direct arterial vasodilators. For each class, it provides examples of drugs, their mechanisms of action, advantages, indications, side effects and other relevant information. Diuretics are further broken down into their types, mechanisms, effects and side effects.
1. The document discusses cardiovascular pharmacology, focusing on drugs used to treat hypertension and heart failure.
2. Several classes of antihypertensive drugs are described, including diuretics, beta-blockers, ACE inhibitors, calcium channel blockers, and vasodilators.
3. Drugs used to treat heart failure that are mentioned include diuretics, ACE inhibitors, beta-blockers, and vasodilators.
Hypertension is a common condition defined by persistently elevated blood pressure that can lead to serious health issues if left untreated. It is classified based on systolic and diastolic blood pressure readings into normal, elevated, stage 1, or stage 2 categories. Treatment involves both non-pharmacologic and pharmacologic approaches, with the goal of reducing blood pressure to prevent complications. Many classes of antihypertensive medications target different mechanisms involved in blood pressure regulation, including the renin-angiotensin-aldosterone system, sympathetic nervous system, and vasodilation. Proper treatment can effectively control blood pressure and reduce health risks associated with hypertension.
Similar to Hypertension Guidelines By Rodgers Chibale (20)
Fexofenadine is sold under the brand name Allegra.
It is a selective peripheral H1 blocker. It is classified as a second-generation antihistamine because it is less able to pass the blood–brain barrier and causes lesser sedation, as compared to first-generation antihistamines.
It is on the World Health Organization's List of Essential Medicines. Fexofenadine has been manufactured in generic form since 2011.
TEST BANK For Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 14...Donc Test
TEST BANK For Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 14th Edition (Hinkle, 2017) Verified Chapter's 1 - 73 Complete.pdf
TEST BANK For Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 14th Edition (Hinkle, 2017) Verified Chapter's 1 - 73 Complete.pdf
TEST BANK For Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 14th Edition (Hinkle, 2017) Verified Chapter's 1 - 73 Complete.pdf
Breast cancer :Receptor (ER/PR/HER2 NEU) Discordance.pptxDr. Sumit KUMAR
Receptor Discordance in Breast Carcinoma During the Course of Life
Definition:
Receptor discordance refers to changes in the status of hormone receptors (estrogen receptor ERα, progesterone receptor PgR, and HER2) in breast cancer tumors over time or between primary and metastatic sites.
Causes:
Tumor Evolution:
Genetic and epigenetic changes during tumor progression can lead to alterations in receptor status.
Treatment Effects:
Therapies, especially endocrine and targeted therapies, can selectively pressure tumor cells, causing shifts in receptor expression.
Heterogeneity:
Inherent heterogeneity within the tumor can result in subpopulations of cells with different receptor statuses.
Impact on Treatment:
Therapeutic Resistance:
Loss of ERα or PgR can lead to resistance to endocrine therapies.
HER2 discordance affects the efficacy of HER2-targeted treatments.
Treatment Adjustment:
Regular reassessment of receptor status may be necessary to adjust treatment strategies appropriately.
Clinical Implications:
Prognosis:
Receptor discordance is often associated with a poorer prognosis.
Biopsies:
Obtaining biopsies from metastatic sites is crucial for accurate receptor status assessment and effective treatment planning.
Monitoring:
Continuous monitoring of receptor status throughout the disease course can guide personalized therapy adjustments.
Understanding and managing receptor discordance is essential for optimizing treatment outcomes and improving the prognosis for breast cancer patients.
Applications of NMR in Protein Structure Prediction.pptxAnagha R Anil
This presentation explores the pivotal role of Nuclear Magnetic Resonance (NMR) spectroscopy in predicting protein structures. It delves into the methodologies, advancements, and applications of NMR in determining the three-dimensional configurations of proteins, which is crucial for understanding their function and interactions.
Allopurinol, a uric acid synthesis inhibitor acts by inhibiting Xanthine oxidase competitively as well as non- competitively, Whereas Oxypurinol is a non-competitive inhibitor of xanthine oxidase.
Storyboard on Skin- Innovative Learning (M-pharm) 2nd sem. (Cosmetics)MuskanShingari
Skin is the largest organ of the human body, serving crucial functions that include protection, sensation, regulation, and synthesis. Structurally, it consists of three main layers: the epidermis, dermis, and hypodermis (subcutaneous layer).
1. **Epidermis**: The outermost layer primarily composed of epithelial cells called keratinocytes. It provides a protective barrier against environmental factors, pathogens, and UV radiation.
2. **Dermis**: Located beneath the epidermis, the dermis contains connective tissue, blood vessels, hair follicles, and sweat glands. It plays a vital role in supporting and nourishing the epidermis, regulating body temperature, and housing sensory receptors for touch, pressure, temperature, and pain.
3. **Hypodermis**: Also known as the subcutaneous layer, it consists of fat and connective tissue that anchors the skin to underlying structures like muscles and bones. It provides insulation, cushioning, and energy storage.
Skin performs essential functions such as regulating body temperature through sweat production and blood flow control, synthesizing vitamin D when exposed to sunlight, and serving as a sensory interface with the external environment.
Maintaining skin health is crucial for overall well-being, involving proper hygiene, hydration, protection from sun exposure, and avoiding harmful substances. Skin conditions and diseases range from minor irritations to chronic disorders, emphasizing the importance of regular care and medical attention when needed.
3. Introduction
Definition. Hypertension or high blood pressure is a condition in which the
blood pressure in the arteries is chronically elevated.
Systolic blood pressure (SBP) of >140 mmHg or diastolic blood pressure (DBP)
of >90 mmHg.
Blood pressure is the force of blood that is pushing up against the walls of the
blood vessels.
Blood pressure is summarized by 2 measurements. Systolic and Diastolic
1. Systolic – is the amount of pressure in your arteries during the contraction of the
heart muscle.
2. Diastolic – is the amount of pressure in the arteries when the heart rest between
beats. This is the time when the heart fills with blood and gets oxygen.
3
4. Introduction cont.
If the pressure is too high, the heart has to work harder to pump and this
could lead to organ damage and several illnesses such as heart attack, stroke,
heart failure, aneurysm or renal failure.
Pulse pressure
Is the different between systolic and diastolic blood pressure.
This is frequently high in older people with Hypertension. This means that SBP
pressure may be abnormally high but DBP may be normal or low. This
condition is called Isolated systolic hypertension. There is arterial stiffness
which typically accompanies ageing and is exacerbated by HBP.
4
5. Etiology
Hypertension maybe Primary (essential), which may develop as a result of
environmental or genetic causes or secondary hypertension, which has multiple
etiologies.
1.Primary (Essential) hypertension.
This means hypertension with no obvious underlying medical cause and it caters
for 90 – 95% of all the cases.
Risk factors
Genetics
Race
Age
Smoking
Stress
Obesity
5
6. Etiology cont.
Lack of exercise
High levels of salt intake
Insufficient levels of calcium, potassium and magnesium in the body
Excessive consumption of Alcohol
6
7. Etiology cont.
2.Secondary Hypertension
This means hypertension is caused by other medical condition that affects the
kidney, arteries, heart, or endocrine system. This type of hypertension caters
for 5 – 10% of all the cases.
Risk factors
Kidney disease (renal vascular disease)
Endocrine problems (Diabetes, Adrenal and thyroid problems or tumors)
CVS conditions e.g. coarctation
Drugs ( corticosteroids, birth control pills, cocaine…etc)
Pregnancy
7
8. Signs, symptoms and diagnosis
There is no guarantee that a person with hypertension will present any symptoms
of the condition. About 33% per cent of people actually do not know that they
have high blood pressure and this ignorance can last for years. For this reason, it
is advisable to undergo periodic blood pressure screening even when no
symptoms are present.
Extremely high blood pressure may lead to some symptoms, however and these
include:
Severe headache
Fatigue
Dizziness
Nausea
8
9. Signs, symptoms and diagnosis cont.
Problems with vision
Chest pain
Breathing problems
Irregular heartbeat
Blood in the urine
Fainting episodes
Hypertension may be diagnosed by a health professional who measures blood
pressure by using a devise called Sphygmomanometer.
9
10. Signs, symptoms and diagnosis cont.
Investigations
Urinalysis for
Blood
Protein
Glucose
Plasma creatinine and cholesterol
ECG to detect left ventricular hypertrophy or evidence of coronary artery disease
Chest radiography for cardiomegaly, heart failure, coarctation of aorta (in selected
patients).
10
12. Treatment
Pts with mild hypertension without other cardiac risk factors should be
treated non pharmacologically.
Pts with major risk factors such as DM or heart failure should be treated with
antihypertensives even when the BP is in prehypertension stage.
1.Non Pharmacological
Weight loss (SBP 5-20mmHg)
Limit alcohol intake to no more than 1 oz (30mL) of ethanol per day for men or
0.5oz (15mL) for women or people with lighter weight.( SBP 2-4mmHg)
Reduce sodium intake to no more than 100 mmol/day (2.4 g sodium or 6g sodium
chloride; range of approximate SBP 2-8 mmHg)
12
13. Treatment cont.
Maintain adequate intake of dietary potassium (approximately 90 mmol/day.
Maintain adequate intake of dietary calcium and magnesium for general health.
Stop smoking and reduce intake of dietary saturated fat and cholesterol for overall
cardiovascular health.
Engage in aerobic exercise at least 30 minutes daily for most days (range of
approximate SBP reduction, 4-9 mmHg)
13
14. Treatment cont.
2.Pharmacological
Drug classes
1. Angiotensin-converting enzyme inhibitors ACEs
2. Angiotensin II receptor antagonists ARBs
3. Adrenergic receptor antagonists
i. Alpha blocker
ii. Beta blocker
4. Calcium channel blockers CCBs
5. Diuretics
i. Loop diuretics
ii. Thiazide diuretics
iii. Potassium-sparing diuretics
6. Vasodilators
14
15. Treatment cont.
1.Angiotensin-converting Enzymes inhibitors ACEs
These inhibit the activity of angiotensin-converting enzyme, an enzyme responsible for the
conversion of angiotensin I into angiotensin II, a potent vasoconstrictor.
ACE inhibitors produce vasodilation by inhibiting the formation of angiotensin II
ACE also breaks down bradykinin ( a vasodilator substance).
ACE dilates arteries and veins, promotes renal excretion of sodium and water and inhibit cardiac
and vascular remodeling.
Therapeutic uses
• Hypertension.
• Heart failure.
• Post-myocardial infarction.
15
17. Treatment cont.
ACEs are contraindicated in patients with;
Pregnancy .
Previous angioedema associated with ARBs/ACEs therapy.
Hypersensitivity to ARBs/ACEs.
Examples
• Captopril tab. 12.5 – 50 mg twice daily
• Enalapril tab. 5 – 40 mg daily once / twice.
• Lisinopril tab. 5 – 40 mg once daily.
• Fosinopril tab. 10 – 40 mg once daily
17
18. Treatment cont.
2. Angiotensin II Receptor antagonists/Sartans ARBs
These drugs have very similar effects to ACEs and are used for the same
indications (Hypertension, heart, failure, post-myocardial infarction).
Their mechanism of action, however, is very different from ACE inhibitors, which
inhibit the formation of angiotensin II (AT1).
Therapeutic uses
• Hypertension
• Heart failure
• Post-myocardial infarction
Side effects of ARBs
Dizziness
Headache
Hyperkalemia
Angioedema
Cough
18
19. Treatment
Examples
• Telmisartan tab 40 – 80 mg once daily.
• Losartan 50-500mg twice daily.
• Candesartan 8-32mg once daily
• Olmesartan 20 – 40 mg once daily
3. Adrenergic receptor antagonist
These are drugs that inhibits the function of adrenergic receptor.
There are five Adrenergic receptors, which are divided into two groups, Alpha
blockers and beta blockers.
19
20. Treatment
a. Alpha blockers
Alpha blockers cause blood vessels to dilate, thereby lowering blood pressure.
Alpha blockers are also used to treat Prostate enlargement in men.
Examples
• Methyldopa tab 250 – 500mg daily in two or three divided doses.
Note: Methyldopa is the effective drug to use when treating pregnancy
induced hypertension.
20
21. Treatment cont.
b. Beta blockers
Beta blockers bind to beta-adrenoceptors located in cardia nodal tissue, the
conducting system and contracting myocytes.
Side effects
Bronchoconstriction can occur. Therefore non-selective beta blockers are contra-
indicated in patients with asthma and or chronic obstructive pulmonary diseases.
Cold extremities.
Bradycardia.
Hypotension.
Worsening of heart failure.
21
22. Treatment cont.
Examples
• Atenolol tab. 25 – 100mg daily once/in divided doses.
• Propranolol tab. 40 -320 mg daily once /in divided doses.
• Metoprolol tab. 50 – 100 mg once /in divided doses
4. Calcium channel blockers CCBs
CCBs bind to L-type calcium channels located on cardiac myocytes and
cardiac nodal tissue (sinoatrial and atrioventricular nodes). These channels
are responsible for regulating the influx of calcium into cardiomyocytes,
which in turn stimulates cardiac myocyte contraction.
22
24. Treatment cont.
5. Diuretics
Diuretics drugs increases urine output by the kidney (i.e., promote diuresis).
This is accomplished by altering how the kidneys handles sodium. If the
kidney excretes more sodium, then water excretion will also increase.
Most diuretics produce diuresis by inhibiting the reabsorption of sodium at
different segments of the renal tubular system.
There are 3 common types of diuretics and these are;
a. Loop diuretic
b. Thiazide diuretic
c. Potassium-sparing diuretic
24
25. Treatment cont.
a. Loop diuretics
These are the most powerful diuretics.
The inhibit the sodium-potassium-chloride cotransporter in the thick ascending
limb. This transporter normally reabsorbs about 25% of the load; therefore
inhibition of this pump can lead to a significant increase in the distal tubular
concentration of sodium, reduced hypertonicity of the surrounding interstitium
and less water reabsorption in the collecting duct.
Side effects
Hypokalemia
Dehydration
Anemia
Diarrhea
Anorexia
25
26. Treatment cont.
Drug interaction with Loop diuretics
• NSAID-reduce diuretic efficacy.
• Corticosteroids – enhance hypokalemia
• Aminoglycosides-enhance ototoxicity, nephrotoxicity.
Example of loop diuretics
Furosemide 20 – 80 daily in divided doses
b. Thiazide diuretic
These are most commonly used diuretics, they inhibit the sodium-chloride
transporter in the distal tubule. Because this transporter only reabsorb about 5%
of filtered sodium, these diuretics are less efficacious than loop diureticsin
producing diuresis natriuresis.
26
27. Treatment cont.
Side effects of Thiazides
• Hypokalemia
• Dehydration
• Hyperglycemia in diabetes
• Hypotension
Drug interaction with Thiazides
• NSAID- reduce efficacy
• Beta blockers – potentiates hyperglycemia, hyperlipidemia
• Corticosteroids – enhance hypokalemia
Example of Thiazides
• Hydrochlorothiazide 25mg daily once
27
28. Treatment cont.
c. Potassium-sparing diuretics
unlike loop and thiazide diuretics, some of these drugs do not act directly on
sodium transport. Some of these drugs in this class antagonize the action of
aldosterone (aldosterone receptor antagonists) at the distal segment of the
distal tubule.
This cause more sodium and water to pass into the collecting duct and be
excreted in the urine.
They are called potassium-sparing diuretics because they do not produce
hypokalemia like loops and thiazides diuretics.
28
30. Treatment cont.
6. Vasodilators
As the name implies, vasodilators drugs relax the smooth muscles in the blood
vessels, which causes the vessels to dilate.
Dilation of arterial (resistance) vessels leads to a reduction in systemic vascular
resistance, which leads to fall in arterial blood pressure.
Example of vasodilators
• Hydralazine 10 - 50mg daily q.i.d (i.v/i.m 20-40mg repeat as necessary)
Side effects
• Headache
• Palpitation
• Conjunctivitis
• Hypotension
30
31. Treatment Guidelines.
First drug Second drug Comment
Effective combination
ACEs or ARBs plus Calcium channel blocker Diabetes, lipid abnormalities
ACEs or ARBs plus Thiazides diuretics Heart failure, post stroke
ACEs or ARBs plus Beta-blockers Post myocardial infarction, heart failure
Beta-blocker plus Dihydropyridine Calcium Channel Blocker Coronary heart disease
Thiazide diuretics Calcium channel blocker
Thiazide diuretics Beta-blockers Not recommended in diabetes, glucose intolerance,
metabolic syndrome.
Combination to use with care
Diltiazem plus Beta-blockers Due to risk of heart block, risk is less with verapamil
ACEs plus Potassium-sparing diuretics Due to risk of hyperkalemia
Combination to avoid
ACEs plus ARBs Increased risk of renal dysfunction
Verapamil Beta-blocker Due to risk of heart block
31
32. Treatment Guideline cont.
Drug treatment strategy to reach blood pressure target
1 Starting drug treatment
Start with low-moderate recommended dose of first-line drug. If not well tolerated, change
to a different drug class, again start with low-moderate recommended dose.
2 If target not reached after 3 months.
Add a second drug from a different pharmacological class at a low-moderate dose, rather
than increasing the dose of the first drug. This maximizes antihypertensive efficacy, while
minimizing adverse effects.
3 If target not reached after 3 months.
If both antihypertensives drugs have been well tolerated, increase the dose of one drug
(excluding thiazide diuretic) incrementally to the maximal recommended dose before
increasing the dose of the other drug.
32
33. Treatment Guideline cont.
4 If target not reached after 3 months.
If, despite maximal dose of at least 2 drugs, a third drug class may be started at a low-
moderate dose. It is advisable to reassess for non-adherence, secondary hypertension
and hypertensive effects of other drugs, treatment resistant state due to sleep apnea,
undisclosed use of alcohol or recreational drugs or high salt intake.
5 If blood pressure remain elevated, consider seeking specialist advice.
33