Term
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Definition
Persistent elevated BP >130/85
Leads to increased TPR & decreased CO which can increase the risk of stroke, angina, CHF, MI, chronic renal failure, retinal lesions & blindness |
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Term
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Definition
| No identifiable cause; 85-90% of people with HTN have this |
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Term
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Definition
| Identifiable cause; 6-10% of people with HTN have this |
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Term
| Isolated Systolic HTN (ISH) |
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Definition
Common w/ aging. Defined as systolic >160 & diastolic <90.
Increased arterial stiffness & PVR increases amount of pump pressure required for circulation leading to an increase in systolic BP & decrease in diastolic BP
Widening pulse pressure is a good indicator
Strongly associated w/ stroke |
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Term
| *Clonidine (Kapvay, Catapres) |
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Definition
Centrally-acting sympathetic agonist;
Stimulates alpha2 receptors in CNS leading to decreased NE release
See vasodilation, decreased HR & BP: ISH. Do NOT d/c abruptly - causes rebound HTN. Causes sedation, dry mouth, horrible taste, constipation, & edema. Available as a transdermal
Drug of last choice & usually used w/ another drug |
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Term
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Definition
Peripherally-acting sympathetic antagonist;
Depletes stores of catecholamines in neurons
Decreased TPR & CO. Causes sedation, depression (some people have killed themselves), increased GI motility, nasal stuffiness |
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Term
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Definition
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Term
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Definition
Beta1 blocker
Do NOT use in COPD/diabetics |
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Term
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Definition
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Term
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Definition
alpha1, beta1&2 blocker
Decreases TPR w/o a reflex increase in HR |
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Term
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Definition
Bronchoconstriction (better in cardioselective (beta1 blocking) agents
Sleep disorders
Rebound HTN
Masks signs of hypoglycemia (diabetes)
*Exercise intolerance
Tiredness |
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Term
| Beta-blocker contraindications |
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Definition
CHF
Bradycardia
Asthma
*Caution in diabetes (may mask signs of hypoglycemia), COPD, PVD |
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Term
| *Hyrdalazine (Apresoline) |
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Definition
Peripheral arterial vasodilators
Directly relaxes arterials via decrease in Ca channel flux in smooth muscle cells. Decrease TPR (decrease afterload)
Causes reflex increase HR; decrease Na & H2O retention; *may cause drug induced SLE; *may be used in pregnant ladies |
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Term
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Definition
Peripheral arterial vasodilators
Directly relaxes arterioles via decreased Ca channel flux in smooth muscle cells. Decreased TPR (decreased afterload)
Used for refractory HTN only. Causes hypertrichosis |
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Term
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Definition
Arterial-venous vasodilaors
Converted to nitric oxide which is a vasodilator (decrease both pre/afterload)
Given IV in hypertensive crisis; hospital use only |
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Term
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Definition
Arterial-venous vasodilator
Alpha1 blocker - causes vasodilation, decrease TPR
Good for mild-moderate HTN. Causes first dose syncope |
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Term
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Definition
CCB
Vasodilation, decreased TPR
May cause AV node block, CHF, constipation, dizziness. |
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Term
*Nifedipine (Procardia)
*Amlodipine (Norvasc) |
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Definition
CCB
Vasodilation, decreased TPR
May cause edema, hypotension, HA, dizziness, increased HR |
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Term
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Definition
ACEI
Once a day dosing. DO NOT USE DURING PREGNANCY |
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Term
*Lisinopril (Prinivil)
*Losartan (Cozaar)
*Valsartan (Diovan) |
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Definition
ACEI & ARBs
Once a day dosing. Causes a cough (except for Diovan), first dose syncope, dizziness, GI SE. DO NOT USE DURING PREGNANCY |
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Term
| ACEI + ARBS as combo drugs |
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Definition
Almost all are available as combo drugs b/c of hyperkalemia
Usually combined w/ hydrochlorothiozide (HCT), a diuretic
Used for HF patient/higher BP
Valsartan is also combined w/ Amlodipine (CCB; Exforge)
Watch for angioedema! |
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Term
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Definition
Direct renin inhibitor approved for HTN
Do not use in 2nd or 3rd trimester of pregnancy |
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Term
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Definition
Aldosterone antagonist used for HF & HTN
Do not use in 2nd or 3rd trimester of pregnancy
May cause cough, monitor for angioedema |
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Term
| *Hydrachlorothiazide (HCT) & Furosemide (Lasix) |
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Definition
Most common anti-HTN diuretics
May cause dizziness and electrolyte imbalances |
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Term
| *Chlorthalidone (Thalitone) or HCTZ |
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Definition
Diuretic
Should be considered first line agents for pts w/ stage 1 HTN
SE: K+ loss, dehydration, dizziness, hyperuricemia |
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