HTN
Biggest CVD risk factor, and is often asymptomatic, regular screening is crucial.
·
so
Always investigate for underlying cause.
·
Stage 1HTN: 0140/90 minty in clinical setting 1 thresholds are 5
mmHg lower
/
stage -160/100 minty in clinical setting average measurements (ABPM).
2 HTN: in home
Severe HTN: -
180/ 118 mmHg
Drugs:
·
inhibitor:
ACE (e.g. Ramipril, lisinopril). inhibits RAAS to vasodilate and reduce water volume.
Alternative is ARB (e.g. Losartan, Candesartan).
contraindicatedin Pregnancy.
Cat Channel Blocker: Non
Rate-limiting:acton vessels used in HTN. (e.g. Amlodipine).
·
Rate-limiting:act heart. (e.g. Diltiazem, Verapamil).
on
contraindicated CCBS
in HE,
Bradycardia, HeartBlock.
·
iyetic:can use thiazide, thiazide-like, loop, ktsparing.
·
a-Blocker: vasodilate. (e.g. Doxazosin, Tamsulo sin -
for HTN/B9H combined). I as
not
↑ commonly
Bisoprodol).
Programaldil.
·
B-Blocker:Cardio selective:used in HTN. e.g. used
Non-selective: (e.g.
Management:
Step inhibitor if
1:ACE -55/non-black,
OR CaChannel Blocker if 55or black.
Step 2:ACE
inhibitor + CaChannel Blocker
Step 3:ACE
inhibitor + CaChannel Blocker + Diuretic MANAGEMENT PATHWAY
Old age and black reduced Renin,
ethnicity causes
inhibitors
SO ACE are not effective.
Treatment
goal is -140/90 mmHg,
·
and -130/80 mmHg in Diabetics.