Pharmacotherapy of Cardiovascular Diseases: Hypertension Management
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Questions and Answers

Hypertension (HTN) is also known as High Blood Pressure (HBP). BP = CO x TPR. CO stands for Cardiac Output and TPR stands for Total Peripheral ________.

Resistance

Stroke volume is influenced by cardiac preload, cardiac afterload, and _________.

Contractility

Excess sodium intake and renal sodium retention can lead to increased fluid volume, impacting cardiac preload and ultimately affecting stroke volume. This mechanism is associated with the pathogenesis of _________.

Hypertension

In hypertension management, lifestyle modifications such as dietary changes to reduce sodium intake can help in controlling blood pressure. Sodium intake restriction helps in preventing excess fluid volume, thus reducing cardiac preload and overall blood pressure. This approach is particularly important in the treatment of _________.

<p>Hypertension</p> Signup and view all the answers

Antihypertensive medications like calcium channel blockers work by reducing total peripheral resistance, thus lowering blood pressure. These drugs are commonly used in the treatment of _________.

<p>Hypertension</p> Signup and view all the answers

Beta-blockers are a class of antihypertensive drugs that work by reducing heart rate and contractility. These medications are effective in managing high blood pressure by decreasing cardiac output. Beta-blockers are commonly prescribed in the treatment of _________.

<p>Hypertension</p> Signup and view all the answers

_______ is a first-line agent recommended by the 2017 ACC/AHA Guidelines for hypertension management.

<p>Diuretics</p> Signup and view all the answers

Patients with Diabetes Mellitus (DM) or Chronic Kidney Disease (CKD) are automatically classified as high risk according to the ACC/AHA Guidelines due to their condition, placing them in the _______ category.

<p>high-risk</p> Signup and view all the answers

The 2017 ACC/AHA Guidelines recommend _______ as a first-line agent for hypertension management.

<p>ACEIs/ARBs</p> Signup and view all the answers

_______ are used as first-line agents for hypertension management according to the 2017 ACC/AHA Guidelines.

<p>CCB (Calcium Channel Blockers)</p> Signup and view all the answers

It is important to monitor for adverse effects when using _______ for hypertension management.

<p>beta-blockers</p> Signup and view all the answers

The 2017 ACC/AHA Guidelines recommend using _______ equations for risk assessment in hypertension management.

<p>Pooled Cohort</p> Signup and view all the answers

Consider initiation of 2 antihypertensive agents of different classes for patients with stage 2 hypertension, especially if BP is ≥150/90 mm Hg. Step 1: 1st line agent could be ACEI, ARBs, CCB, or ____________.

<p>thiazide</p> Signup and view all the answers

In elderly patients (age >55-65 yr) and Blacks, the preferred 1st line antihypertensive agents are CCB or ____________.

<p>thiazide</p> Signup and view all the answers

If blood pressure goal isn’t achieved despite adequate adherence, the therapy should be titrated up in a stepwise approach. Step 2: Either maximize the dose of the 1st agent or add a ____________ agent.

<p>2nd</p> Signup and view all the answers

In hypertension management, if still not controlled after adding a 3rd agent, which is considered resistant hypertension, a 4th agent such as a beta-blocker, alpha-blocker, or aldosterone antagonist may be added. This step is known as Step ____________.

<p>4</p> Signup and view all the answers

Strategies to dose antihypertensive drugs include starting with one drug, titrating to the maximum dose, and then adding a ____________ drug.

<p>2nd</p> Signup and view all the answers

For patients with blood pressure ≥150/90 mmHg above their goal, beginning with 2 drugs at the same time may be recommended. If the goal BP is not achieved with 2 drugs, a ____________ drug may be added.

<p>3rd</p> Signup and view all the answers

Flashcards

What does TPR stand for?

Total Peripheral Resistance (TPR) is a measure of the resistance to blood flow in the circulatory system. It represents the overall opposition the blood encounters as it travels through the blood vessels.

What does CO stand for?

Cardiac Output (CO) is the amount of blood pumped by the heart per minute. It represents the efficiency of the heart in delivering blood to the body.

What is stroke volume?

Stroke volume is the volume of blood ejected by the heart's left ventricle with each beat. It reflects how much blood is expelled with each contraction.

What is afterload?

Afterload is the force the heart has to overcome to eject blood. It's the resistance the heart faces against its pumping action.

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What is preload?

Preload is the amount of stretching of the heart muscle fibers before contraction. It reflects the volume of blood filling the heart's ventricle.

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What is contractility?

Contractility is the force of contraction of the heart muscle. It reflects the strength and efficiency of the heartbeat.

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What is Hypertension?

Hypertension, also known as high blood pressure (HBP), is a condition where the pressure of blood against the artery walls is consistently too high.

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How does sodium relate to hypertension?

Sodium intake and renal sodium retention can increase fluid volume, thereby increasing preload and ultimately affecting stroke volume. This contributes to the development of hypertension.

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How do dietary changes help manage hypertension?

Dietary modifications to reduce sodium intake can help control blood pressure. By limiting sodium, you reduce fluid volume, lowering preload and overall blood pressure.

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How do calcium channel blockers work?

Calcium channel blockers are antihypertensive medications that work by relaxing blood vessels, thereby reducing TPR and lowering blood pressure.

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How do beta-blockers work?

Beta-blockers are a class of antihypertensive drugs that reduce heart rate and contractility. By decreasing cardiac output, they effectively manage high blood pressure.

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What are diuretics and how are they used in hypertension?

Diuretics are a class of medications that help the body eliminate excess fluid, thereby reducing blood volume and lowering blood pressure. They are often used as a first line treatment for hypertension.

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Which patient groups are considered high-risk for hypertension?

Patients with diabetes mellitus (DM) or chronic kidney disease (CKD) are considered high-risk for hypertension due to their complications and need special attention.

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What are ACEIs/ARBs and how are they used in hypertension?

ACEIs/ARBs are a class of drugs that block the renin-angiotensin system, leading to vasodilation (blood vessel relaxation) and a decrease in blood pressure.

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What are CCBs and how are they used in hypertension?

Calcium Channel Blockers (CCBs) are antihypertensive drugs that relax blood vessels. They are often used as a first-line treatment for hypertension.

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What are important considerations when using beta-blockers?

Beta-blockers can have adverse effects such as fatigue, bradycardia, and bronchospasm. It's crucial to monitor patients for these side effects.

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What risk assessment tool is recommended for hypertension management?

The 2017 ACC/AHA Guidelines recommend using pooled cohort equations to assess the risk of cardiovascular disease, a key factor in hypertension management.

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What are the recommendations for treating stage 2 hypertension?

In patients with stage 2 hypertension and blood pressure ≥ 150/90 mmHg, consider initiating 2 antihypertensive agents of different classes. The first agent can be ACEI, ARB, CCB, or thiazide.

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Which antihypertensive agents are preferred for elderly and Black patients?

Elderly patients (age > 55-65 years) and Black patients may benefit from CCB or thiazide as first-line antihypertensive agents.

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If blood pressure remains uncontrolled, what is the next step in treatment?

If blood pressure remains uncontrolled despite adequate medication adherence, increase the first agent's dose or add a second agent to the treatment plan.

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What is step 4 in hypertension management?

Step 4 of hypertension management involves adding a fourth agent, such as beta-blocker, alpha-blocker, or aldosterone antagonist, for resistant hypertension.

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Describe the common strategy for dosing antihypertensive medication.

Antihypertensive medication strategies can involve starting with one drug, increasing the dosage, and then adding a second drug if needed.

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What is the recommended treatment approach for patients with very high blood pressure?

For patients with blood pressure ≥ 150/90 mmHg, initiating two drugs at the beginning of treatment can be beneficial. If the goal BP is not achieved with 2 drugs, a third drug might be added.

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