Antihypertensive Agents: Understanding Hypertension

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11 Questions

What is the primary characteristic that distinguishes essential hypertension from secondary hypertension?

Absence of identifiable secondary cause

What is the common effect of sustained arterial hypertension on blood vessels in the kidney, heart, and brain?

Damage to blood vessels

Which of the following is NOT a risk factor for essential hypertension?

Renal failure

What is the primary goal of treating hypertension?

To prevent damage to blood vessels and reduce morbidity and mortality rate

What is the classification of blood pressure if the systolic BP is above 140 mm Hg or diastolic BP is above 90 mm Hg?

Hypertension

What is the percentage of hypertension cases that are attributed to essential hypertension?

95%

Which of the following anti-hypertensive drug classes acts by decreasing cardiac output?

Beta adrenergic blockers

What is the primary mechanism of action of centrally acting anti-hypertensive agents?

Inhibition of the sympathetic nervous system

Which of the following lifestyle modifications is not a recommended non-pharmacological intervention for hypertension?

Decrease in hydration levels

What is the primary site of action of alpha blockers in the treatment of hypertension?

Blood vessels

Which of the following anti-hypertensive agents acts by direct relaxation of blood vessels?

Direct vasodilators

Study Notes

Definition and Classification of Hypertension

  • Hypertension is defined as systolic BP above 140 mm Hg or diastolic BP above 90 mm Hg
  • Classification of hypertension:
    • Normal: systolic BP ≤ 100 mm Hg and diastolic BP ≤ 90 mm Hg
  • There are two types of hypertension: essential and secondary hypertension

Essential Hypertension

  • Accounts for ~95% of all cases of hypertension
  • Also referred to as primary or idiopathic hypertension
  • Characterized by an absence of identifiable secondary cause
  • Risk factors include:
    • Sedentary lifestyle
    • Obesity
    • Insulin resistance (metabolic syndrome)
    • Salt/sodium sensitivity
    • Alcohol intake
    • Age
    • Family history

Secondary Hypertension

  • Attributed to an identifiable cause
  • Examples of causes:
    • Aldosteronism
    • Hyperthyroidism
    • Glucocorticoid excess
    • Renovascular disease
    • Renal failure
    • Pheochromocytoma
  • Treatment targets the underlying cause

Importance of Treating Hypertension

  • Sustained arterial hypertension damages blood vessels in the kidney, heart, and brain
  • Leads to increased incidence of renal failure, cardiac failure, and stroke
  • Effective pharmacologic lowering of blood pressure prevents damage to blood vessels and reduces morbidity and mortality rate

Treatment of Hypertension

  • Two therapeutic interventions: non-pharmacologic and pharmacological

Non-Pharmacologic Therapy

  • Low sodium chloride diet
  • Weight reduction
  • Exercise
  • Cessation of smoking
  • Decrease in excessive consumption of alcohol
  • Avoid stress

Pharmacological Therapy

  • Anti-hypertensive drugs lower blood pressure by decreasing cardiac output or total peripheral vascular resistance or both
  • Classified according to principal regulatory site or mechanism of action:
    • Beta adrenergic blockers (e.g. Atenolol, Propranolol, Metoprolol, Labetalol)
    • Alpha blockers (e.g. Prazosin)
    • Centrally acting anti-hypertensive (e.g. Methyldopa)
    • Diuretics
    • Direct vasodilators
    • Angiotensin converting enzyme inhibitors
    • Angiotensin II receptor blockers
    • Calcium channel blockers

Learn about hypertension, its classification, and the two general types of hypertension. This quiz covers the definition of hypertension, blood pressure levels, and essential hypertension.

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