Race-Specific Drug Selection for Hypertension and Diabetes

Hypertensive emergency and hypertensive urgency

SBP exceeds 180 mm Hg or DBP exceeds 120 mm Hg

Secondary hypertension, poorly controlled hypertension, undiagnosed hypertension, abrupt discontinuation of medications

<p>The exact frequency is a matter of clinical judgment and varies with the patient’s condition</p> Signup and view all the answers

<p>Slowing the heart rate and lowering the blood pressure.</p> Signup and view all the answers

<p>Asthma, reactive airway disease, COPD, heart block, symptomatic bradycardia.</p> Signup and view all the answers

<p>Carvedilol.</p> Signup and view all the answers

<p>Acts through the central nervous system, mediated alpha-adrenergic stimulation in the brain, producing blood pressure reduction.</p> Signup and view all the answers

<p>Muscle cramps, joint stiffness, sexual dysfunction, constipation, shortness of breath, edema, dizziness.</p> Signup and view all the answers

<p>Block reabsorption of sodium and water in renal tubules.</p> Signup and view all the answers

<p>Significant CKD, severe hepatic disease, hyperkalemia.</p> Signup and view all the answers

<p>Block beta-adrenergic receptors and reduce cardiac workload.</p> Signup and view all the answers

<p>Thiazide or thiazide-type diuretics, ACE inhibitors, ARBs, and CCBs.</p> Signup and view all the answers

<p>Thiazide diuretic or CCB (not an ACE inhibitor or an ARB).</p> Signup and view all the answers

<p>Directly affect vascular smooth muscle, increase renal blood flow, and decrease cardiac output.</p> Signup and view all the answers

<p>Inhibit the conversion of angiotensin I to angiotensin II, reducing peripheral resistance and potentially life-threatening complications.</p> Signup and view all the answers

<p>CCB and/or thiazide-type diuretic.</p> Signup and view all the answers

<p>ACE inhibitor, ARB, CCB, and/or thiazide-type diuretic.</p> Signup and view all the answers

<p>Thiazide diuretics (e.g., chlorthalidone, hydrochlorothiazide) used as monotherapy or with an ACE inhibitor, ARB, or CCB.</p> Signup and view all the answers

<p>If the patient has a systolic pressure greater than 140 mm Hg or a diastolic blood pressure greater than 90 mm Hg.</p> Signup and view all the answers

<p>Resistant hypertension is diagnosed when a patient takes at least three antihypertensive medications from different classes (including a diuretic) and the blood pressure is still not controlled (i.e., not less than 130/80 mm Hg). A patient with controlled blood pressure but who requires at least four antihypertensive medications in order to maintain that control is also considered to have resistant hypertension.</p> Signup and view all the answers

<p>The risk factors for resistant hypertension include older age, being African American, and having obesity, CKD, or diabetes.</p> Signup and view all the answers

<p>The drugs used in the management of primary hypertension belong to several different groups, including ACE inhibitors, angiotensin II receptor blockers (ARBs), antiadrenergics, calcium channel blockers (CCBs), diuretics, and direct vasodilators.</p> Signup and view all the answers

<p>In general, these drugs act to decrease blood pressure by decreasing cardiac output or peripheral vascular resistance.</p> Signup and view all the answers

<p>CCBs, alpha1 receptor blockers, and the alpha-/beta-adrenergic blocker labetalol.</p> Signup and view all the answers

<p>ACE inhibitors, some ARBs (e.g., losartan and telmisartan), and beta-adrenergic blockers.</p> Signup and view all the answers

<p>Low circulating renin, increased salt sensitivity, and a higher incidence of obesity.</p> Signup and view all the answers

<p>ACE inhibitors.</p> Signup and view all the answers

<p>Reduction of proteinuria and slowing progression of renal impairment.</p> Signup and view all the answers

<p>They may cause or aggravate proteinuria and renal damage.</p> Signup and view all the answers