Hypertension & Dyslipidemia Medication

Medication List for Hypertension & Dyslipidemia Management

• Thiazide and Thiazide-Like Diuretics: First-line treatment for hypertension; Drugs include Hydrochlorothiazide, Chlorthalidone, Indapamide, Metolazone. Inhibit sodium and chloride reabsorption, reducing blood volume and lowering blood pressure. Less effective in kidney impairment. Can be combined with loop diuretics for resistant hypertension. Avoid nighttime dosing to prevent nocturia.

ACE Inhibitors

• Medications: Lisinopril, Ramipril, Enalapril, Benazepril, Captopril. First-line for hypertension, heart failure, and Chronic Kidney Disease. Inhibit angiotensin-converting enzyme, leading to vasodilation and reduced aldosterone, lowering blood pressure.

• Pharmacokinetics: Oral absorption, hepatic metabolism, renal excretion.

• Adverse Effects/Details: May cause hyperkalemia, dry cough, and angioedema. Avoid in pregnancy and bilateral renal artery stenosis, monitor kidney function and electrolytes.

Angiotensin Receptor Blockers (ARBs)

• Medications: Losartan, Valsartan, Irbesartan, Telmisartan, Candesartan. Alternative to ACE inhibitors for hypertension. Block angiotensin II receptors, preventing vasoconstriction and lowering blood pressure.

• Pharmacokinetics: Hepatic metabolism, renal/fecal excretion.

Dihydropyridine Calcium Channel Blockers (CCBs)

• Medications: Amlodipine, Nifedipine, Nicardipine. Often effective for hypertension, especially in Black patients and the elderly. Inhibit calcium influx in vascular smooth muscle, leading to vasodilation and reducing blood pressure.

• Pharmacokinetics: CYP3A4 metabolism, fecal/renal excretion.

• Adverse Effects/Details: Common side effects include peripheral edema, flushing, and headache. Avoid immediate-release nifedipine due to increased risk of myocardial infarction.

Loop Diuretics

• Medications: Furosemide, Torsemide, Bumetanide. Used for resistant hypertension, heart failure, and renal failure; Blocks Na+/K+/2Cl- transporter, causing diuresis (increased urination) and lowering blood pressure.

• Pharmacokinetics: Renal elimination, short half-life.

• Adverse Effects/Details: More potent than thiazides but can cause hypokalemia (low potassium), dehydration, and ototoxicity (damage to the inner ear). Monitor electrolytes and kidney function.

Beta-Blockers

• Medications: Metoprolol, Atenolol, Carvedilol, Labetalol. Often used for post-myocardial infarction (heart attack), heart failure and arrhythmias (not first-line for hypertension). Block beta-1 receptors reducing heart rate, cardiac output, and renin secretion, indirectly lowering blood pressure.

• Pharmacokinetics: Hepatic metabolism, renal excretion.

• Adverse Effects/Details: Can cause bradycardia (slow heart rate), fatigue, and depression. Avoid in asthma due to bronchospasm risk.

Statins (HMG-CoA Reductase Inhibitors)

• Medications: Atorvastatin, Rosuvastatin, Simvastatin, Pravastatin. First-line for dyslipidemia (high cholesterol). Inhibit HMG-CoA reductase reducing cholesterol synthesis and increasing LDL clearance.

• Pharmacokinetics: Hepatic metabolism, fecal excretion, check lipid panel and liver enzymes regularly.

• Adverse Effects/Details: Can cause myopathy (muscle problems) and liver toxicity. Avoid in pregnancy (teratogenic).

Ezetimibe (Zetia®)

• Use: Adjunct to statins for LDL reduction. Inhibits cholesterol absorption in the small intestine, lowering LDL levels.

• Pharmacokinetics: Hepatic metabolism, fecal excretion.

• Details: Less effective than statins but well tolerated. Used in combination with statins for additional LDL reduction.

Overview of medications for hypertension and dyslipidemia, like thiazide diuretics and ACE inhibitors. Thiazides reduce blood volume by inhibiting sodium and chloride reabsorption. ACE inhibitors, such as lisinopril and ramipril, promote vasodilation and reduce aldosterone levels.