p.2
Definition and Risk Factors of Hypertension
How does lowering moderately elevated blood pressure affect cardiovascular disease risk?
It significantly reduces the risk of cardiovascular disease.
p.27
Mechanisms of Action and Adverse Effects of Antihypertensive Drugs
What is the mechanism of action of metoprolol?
Metoprolol is a selective beta-1 adrenergic antagonist that decreases heart rate and contractility, leading to reduced blood pressure.
p.8
Matching Antihypertensive Drugs to Patient Conditions
Can β-Adrenoceptor Blocking Agents be used in patients with asthma?
Caution is advised, as they can potentially exacerbate asthma symptoms.
p.25
Matching Antihypertensive Drugs to Patient Conditions
What is a key consideration when treating hypertension?
Hypertension may coexist with other diseases that can be aggravated or may benefit from antihypertensive drugs.
p.8
Mechanisms of Action and Adverse Effects of Antihypertensive Drugs
How do β-Adrenoceptor Blocking Agents work?
They block the effects of adrenaline on β-adrenergic receptors, leading to decreased heart rate and blood pressure.
p.28
Mechanisms for Controlling Blood Pressure
How do thiazide diuretics work?
They inhibit active reabsorption of NaCl in the distal convoluted tubule by interfering with a specific Na+/Cl− cotransporter.
p.2
Definition and Risk Factors of Hypertension
What are some complications of chronic hypertension?
Heart disease, chronic kidney disease, and stroke.
p.15
Drug Classes for Hypertension Treatment
What are two examples of thiazide diuretics?
Hydrochlorothiazide and Chlorthalidone.
p.19
Mechanisms of Action and Adverse Effects of Antihypertensive Drugs
What is the mechanism of action of ACE inhibitors?
They block the enzyme ACE, which cleaves angiotensin I to form angiotensin II.
p.27
Mechanisms of Action and Adverse Effects of Antihypertensive Drugs
What is the mechanism of action of thiazide diuretics?
Thiazide diuretics inhibit sodium reabsorption in the distal convoluted tubule, leading to increased excretion of sodium and water, which lowers blood pressure.
p.22
Hypertensive Emergencies and Urgencies
What is resistant hypertension?
Blood pressure that remains elevated above goal despite an optimal three-drug regimen that includes a diuretic.
p.23
Patient Compliance in Antihypertensive Therapy
What is the primary goal of hypertension therapy?
To prevent future disease consequences rather than relieving current discomfort.
p.22
Hypertensive Emergencies and Urgencies
What is a hypertensive urgency?
Severe elevation in blood pressure without evidence of target organ damage.
p.11
Mechanisms of Action and Adverse Effects of Antihypertensive Drugs
What are common adverse effects of Clonidine?
Sedation, dry mouth, and constipation.
p.23
Drug Classes for Hypertension Treatment
Which medications are recommended to initiate therapy for hypertension?
Thiazide diuretic, ACE inhibitor, ARBs, or calcium channel blocker.
p.7
Mechanisms for Controlling Blood Pressure
What effect does α1 activation have on blood pressure?
It increases blood pressure.
p.2
Recent Guidelines for Hypertension Management
What is the primary goal of antihypertensive therapy?
To reduce cardiovascular and renal morbidity and mortality.
p.11
Drug Classes for Hypertension Treatment
What are the therapeutic uses of Clonidine?
Used for hypertension that has not responded adequately to treatment with two or more drugs and in hypertension complicated by renal disease.
p.6
Mechanisms for Controlling Blood Pressure
What is the reflex response of the sympathetic and parasympathetic nervous systems to low blood pressure?
↑ sympathetic and ↓ parasympathetic output to the heart, resulting in vasoconstriction and ↑ cardiac output.
p.15
Matching Antihypertensive Drugs to Patient Conditions
With which class of drugs are thiazide diuretics often used in combination for treating hypertension?
All of the above (Beta-blockers, ACE inhibitors, Calcium channel blockers).
p.20
Mechanisms of Action and Adverse Effects of Antihypertensive Drugs
What are the adverse effects of ARBs compared to ACE inhibitors?
Adverse effects are similar to those of ACE inhibitors, but cough is less common.
p.7
Mechanisms for Controlling Blood Pressure
What is the effect of α1 blocking and α2 activation on blood pressure?
It decreases blood pressure.
p.24
Recent Guidelines for Hypertension Management
What is the recommendation for Stage 1 Hypertension without ASCVD and 10-year CVD risk <10%?
Start with nonpharmacologic therapy and reassess BP in 3 - 6 months; consider pharmacologic therapy if not at goal.
p.6
Mechanisms for Controlling Blood Pressure
What happens when there is a fall in blood pressure?
Baroreceptors send impulses to cardiovascular centers in the spinal cord.
p.27
Electrolyte Abnormalities Associated with Diuretics
What electrolyte abnormalities commonly occur with thiazide diuretics?
Hypokalemia (low potassium) and hyponatremia (low sodium) are common electrolyte abnormalities associated with thiazide diuretics.
p.15
Mechanisms of Action and Adverse Effects of Antihypertensive Drugs
What are some adverse effects of thiazide diuretics?
Hypokalemia, hyperuricemia, hyperglycemia, and decreased Ca2+ content of urine.
p.12
Drug Classes for Hypertension Treatment
What are Calcium Channel Blockers (CCBs)?
A class of medications that inhibit calcium entry into cells, primarily affecting the heart and blood vessels.
p.8
Mechanisms of Action and Adverse Effects of Antihypertensive Drugs
What are some common side effects of β-Adrenoceptor Blocking Agents?
Side effects may include fatigue, cold extremities, and bradycardia.
p.21
Drug Classes for Hypertension Treatment
What are the therapeutic uses of Hydralazine?
Used for controlling blood pressure in pregnancy-induced hypertension.
p.10
Mechanisms of Action and Adverse Effects of Antihypertensive Drugs
What is the mechanism of action of Methyldopa?
Acts centrally as an α2 agonist.
p.10
Antihypertensive Agents Safe for Pregnancy
What are the therapeutic uses of Methyldopa?
Management of hypertension in pregnancy.
p.7
Drug Classes for Hypertension Treatment
In what cases is Doxazosin used therapeutically?
Only in refractory hypertension cases due to its side effect profile.
p.3
Definition and Risk Factors of Hypertension
How does age relate to hypertension?
Age is a risk factor for hypertension.
p.23
Patient Compliance in Antihypertensive Therapy
What is the most common reason for failure of antihypertensive therapy?
Lack of patient compliance.
p.1
Definition and Risk Factors of Hypertension
What is hypertension?
A condition characterized by consistently high blood pressure.
p.3
Mechanisms for Controlling Blood Pressure
What are the two main factors that control arterial blood pressure?
Cardiac output and peripheral vascular resistance.
p.3
Definition and Risk Factors of Hypertension
What is the relationship between obesity and hypertension?
Obesity is a risk factor for hypertension.
p.25
Matching Antihypertensive Drugs to Patient Conditions
Why is it important to match antihypertensive drugs to patients?
To ensure the treatment is suitable and effective for the patient's specific conditions.
p.11
Mechanisms of Action and Adverse Effects of Antihypertensive Drugs
What is the mechanism of action of Clonidine?
Acts centrally as an α2 agonist.
p.15
Mechanisms of Action and Adverse Effects of Antihypertensive Drugs
In which patients are thiazide diuretics not effective?
Patients with inadequate kidney function.
p.12
Drug Classes for Hypertension Treatment
What are some common types of Calcium Channel Blockers?
Amlodipine, diltiazem, and verapamil.
p.20
Matching Antihypertensive Drugs to Patient Conditions
In which conditions are ARBs used as an alternative to ACE inhibitors?
Hypertension with diabetes, heart failure, or chronic kidney disease.
p.21
Mechanisms of Action and Adverse Effects of Antihypertensive Drugs
What are some adverse effects of Hydralazine?
Fatigue, rash, joint aches, and effusions.
p.12
Mechanisms of Action and Adverse Effects of Antihypertensive Drugs
What are potential side effects of Calcium Channel Blockers?
Swelling, dizziness, and flushing.
p.20
Mechanisms of Action and Adverse Effects of Antihypertensive Drugs
What is the mechanism of action of ARBs?
They block angiotensin II receptor type 1 (AT1), producing arteriolar and venous dilation, and blocking aldosterone secretion, which decreases Na and H2O retention and lowers blood pressure.
p.24
Recent Guidelines for Hypertension Management
What should be done for Elevated BP (120 - 129/<80 mmHg)?
Start with nonpharmacologic therapy and reassess BP in 3 - 6 months.
p.10
Antihypertensive Agents Safe for Pregnancy
Why is Methyldopa preferred for treating hypertension in pregnancy?
Because it is effective and has a safety profile for pregnant patients.
p.18
Mechanisms of Action and Adverse Effects of Antihypertensive Drugs
What is a significant risk associated with Aliskiren?
Increased risk of cough and angioedema.
p.18
Mechanisms of Action and Adverse Effects of Antihypertensive Drugs
What should be noted about Aliskiren in terms of drug interactions?
It is subject to many drug interactions.
p.3
Mechanisms for Controlling Blood Pressure
What system regulates cardiac output and peripheral resistance?
The renin-angiotensin-aldosterone system.
p.9
Matching Antihypertensive Drugs to Patient Conditions
In which patients are β blockers used?
In hypertensive patients with concomitant heart disease.
p.1
Recent Guidelines for Hypertension Management
What are the most recent guidelines for hypertension management?
Focus on lifestyle changes and individualized treatment plans.
p.29
Matching Antihypertensive Drugs to Patient Conditions
How are thiazide diuretics often used in combination therapy?
They are frequently used in combination with other classes of antihypertensives.
p.29
Patient Compliance in Antihypertensive Therapy
What dietary recommendation is often given to patients on thiazides?
To follow a high potassium diet and frequently require potassium supplementation.
p.8
Drug Classes for Hypertension Treatment
What are β-Adrenoceptor Blocking Agents commonly used for?
They are primarily used to treat hypertension and other cardiovascular conditions.
p.22
Hypertensive Emergencies and Urgencies
What defines a hypertensive emergency?
Severe elevations in blood pressure with evidence of target organ damage (systolic ≥ 180 mm Hg or diastolic ≥ 120 mm Hg).
p.12
Mechanisms of Action and Adverse Effects of Antihypertensive Drugs
How do Calcium Channel Blockers help in treating hypertension?
By relaxing blood vessels and reducing heart rate, leading to lower blood pressure.
p.19
Drug Classes for Hypertension Treatment
What are the therapeutic uses of ACE inhibitors?
Hypertension with diabetic nephropathy and as first-line agents in hypertension with chronic kidney disease.
p.22
Hypertensive Emergencies and Urgencies
How is treatment for hypertension directed?
By the type of target organ damage present and/or comorbidities.
p.6
Mechanisms for Controlling Blood Pressure
What role do baroreceptors in the kidney play in blood pressure regulation?
They respond to ↓ blood pressure by releasing the enzyme renin.
p.16
Drug Classes for Hypertension Treatment
What are two examples of potassium-sparing diuretics?
Amiloride and Triamterene (Na channel blockers), Spironolactone (aldosterone antagonist).
p.23
Patient Compliance in Antihypertensive Therapy
How can patient compliance be improved in antihypertensive therapy?
By combining two drug classes in a single pill.
p.14
Drug Classes for Hypertension Treatment
What are examples of loop diuretics used in hypertension treatment?
Furosemide and Bumetanide.
p.14
Mechanisms of Action and Adverse Effects of Antihypertensive Drugs
How do loop diuretics affect other antihypertensives?
They potentiate other antihypertensives.
p.9
Mechanisms of Action and Adverse Effects of Antihypertensive Drugs
What is the mechanism of action of β blockers?
They block β-adrenoceptors, decreasing cardiac output and inhibiting the release of renin.
p.29
Drug Classes for Hypertension Treatment
What is the primary use of thiazides in hypertension treatment?
As single agents primarily in mild to moderate hypertension.
p.21
Mechanisms of Action and Adverse Effects of Antihypertensive Drugs
What is the mechanism of action of vasodilators like Hydralazine?
They relax vascular smooth muscle, leading to decreased peripheral resistance and blood pressure.
p.28
Mechanisms of Action and Adverse Effects of Antihypertensive Drugs
What is the mechanism of action of metoprolol?
It is a β1-selective adrenoreceptor antagonist.
p.15
Mechanisms for Controlling Blood Pressure
What is the mechanism of action of thiazide diuretics?
They increase Na and H2O elimination, causing a decrease in blood volume and cardiac output.
p.7
Mechanisms of Action and Adverse Effects of Antihypertensive Drugs
What is the mechanism of action of Doxazosin?
It blocks α1-adrenoceptors, causing relaxation of both arterial and venous smooth muscle.
p.11
Drug Classes for Hypertension Treatment
What class of drugs does Clonidine belong to?
Centrally Acting Adrenergic Drugs (α2 Agonists).
p.28
Electrolyte Abnormalities Associated with Diuretics
What electrolyte abnormalities are associated with thiazide diuretics?
Hypokalemia, hyponatremia, and hypochloremia.
p.22
Drug Classes for Hypertension Treatment
What types of medications are used in hypertensive emergencies?
CCBs (nicardipine, clevidipine), nitric oxide vasodilators (nitroprusside, nitroglycerin), adrenergic receptor antagonists (phentolamine, esmolol, labetalol), hydralazine, and dopamine agonist fenoldopam.
p.6
Mechanisms for Controlling Blood Pressure
What does renin convert angiotensinogen into?
Angiotensin I, which is then converted to angiotensin II.
p.10
Drug Classes for Hypertension Treatment
What class of drugs does Methyldopa belong to?
Centrally acting adrenergic drugs (α2 agonists).
p.6
Mechanisms for Controlling Blood Pressure
What overall effect does the renin-angiotensin-aldosterone system have on blood pressure?
It contributes to a further ↑ in blood pressure.
p.9
Drug Classes for Hypertension Treatment
What are examples of non-selective β blockers?
Propranolol, Labetalol, and Carvedilol.
p.9
Hypertensive Emergencies and Urgencies
What condition is Labetalol specifically used for?
Gestational hypertension and hypertensive emergencies.
p.29
Mechanisms of Action and Adverse Effects of Antihypertensive Drugs
What do thiazides inhibit to exert their effects?
The active reabsorption of Na+.
p.29
Mechanisms of Action and Adverse Effects of Antihypertensive Drugs
What lipid abnormalities can thiazides worsen?
Hypertriglyceridemia and increased plasma cholesterol.
p.3
Definition and Risk Factors of Hypertension
What is a risk factor for hypertension related to family?
Family history of hypertension.
p.18
Mechanisms of Action and Adverse Effects of Antihypertensive Drugs
What is the mechanism of action of Aliskiren?
Directly and selectively inhibits renin.
p.13
Drug Classes for Hypertension Treatment
What are examples of dihydropyridine calcium channel blockers (CCBs)?
Nifedipine and Amlodipine.
p.24
Recent Guidelines for Hypertension Management
What is the recommendation for Stage 1 Hypertension with ASCVD or 10-year CVD risk ≥10%?
Start with both nonpharmacologic and pharmacologic therapy; reassess BP in 1 month.
p.3
Definition and Risk Factors of Hypertension
How does dietary sodium intake affect blood pressure?
High dietary intake of sodium is a risk factor for hypertension.
p.1
Drug Classes for Hypertension Treatment
What are the different drug classes used for hypertension treatment?
Diuretics, ACE inhibitors, beta-blockers, calcium channel blockers, and ARBs.
p.1
Antihypertensive Agents Safe for Pregnancy
Which antihypertensive agents are safe to use during pregnancy?
Methyldopa and certain beta-blockers.
p.29
Mechanisms for Controlling Blood Pressure
How do thiazides contribute to their antihypertensive effect?
By reducing intravascular volume through sodium and water excretion.
p.18
Mechanisms of Action and Adverse Effects of Antihypertensive Drugs
What are some adverse effects of Aliskiren?
Diarrhea, cough, and angioedema.
p.20
Patient Compliance in Antihypertensive Therapy
Why are ARBs often preferred over ACE inhibitors?
They have fewer cases of cough as an adverse effect.
p.16
Patient Compliance in Antihypertensive Therapy
Why are potassium-sparing diuretics prescribed in combination with other diuretics?
To reduce potassium loss caused by loop and thiazide diuretics.
p.1
Mechanisms for Controlling Blood Pressure
What mechanisms are involved in controlling blood pressure?
Regulation by the nervous system, hormones, and kidney function.
p.13
Matching Antihypertensive Drugs to Patient Conditions
Why might Verapamil or Diltiazem be preferred in patients with hypertension and a rapid heart rate?
They slow heart rate and reduce cardiac workload.
p.29
Matching Antihypertensive Drugs to Patient Conditions
When are thiazides often added as second agents?
When other drugs alone cannot control a patient’s hypertension.
p.12
Matching Antihypertensive Drugs to Patient Conditions
In which conditions are Calcium Channel Blockers particularly effective?
Hypertension, angina, and certain arrhythmias.
p.23
Matching Antihypertensive Drugs to Patient Conditions
When should patients be started on two antihypertensives simultaneously?
If systolic blood pressure is greater than 160 mm Hg or diastolic blood pressure is greater than 100 mm Hg.
p.16
Mechanisms of Action and Adverse Effects of Antihypertensive Drugs
What are some adverse effects of potassium-sparing diuretics?
Hyperkalemia, mental confusion, gynecomastia, and menstrual irregularities.
p.14
Mechanisms of Action and Adverse Effects of Antihypertensive Drugs
What adverse effects are associated with loop diuretics?
Hypokalemia and increased Ca2+ content in urine.
p.3
Definition and Risk Factors of Hypertension
How does smoking affect blood pressure?
Smoking is a risk factor for hypertension.
p.6
Mechanisms for Controlling Blood Pressure
What is the effect of angiotensin II on blood vessels?
It is a potent vasoconstrictor, constricting arterioles and veins, resulting in ↑ blood pressure.
p.6
Mechanisms for Controlling Blood Pressure
How does angiotensin II affect aldosterone secretion?
It stimulates aldosterone secretion, leading to ↑ Na/water reabsorption and ↑ blood volume.
p.16
Mechanisms of Action and Adverse Effects of Antihypertensive Drugs
What is the mechanism of action of potassium-sparing diuretics?
They decrease Na reabsorption and do not promote the secretion of K into the urine.
p.24
Recent Guidelines for Hypertension Management
What should be done for Stage 2 Hypertension?
Start with both nonpharmacologic and pharmacologic therapy; reassess BP in 1 month.
p.1
Matching Antihypertensive Drugs to Patient Conditions
How should antihypertensive drugs be matched to patients?
Based on the patient's concomitant diseases and overall health.
p.1
Definition and Risk Factors of Hypertension
What are some risk factors for hypertension?
Obesity, lack of physical activity, high salt intake, and family history.
p.14
Mechanisms for Controlling Blood Pressure
What is the mechanism of action of loop diuretics?
They block Na and Cl reabsorption and decrease renal vascular resistance.
p.14
Matching Antihypertensive Drugs to Patient Conditions
In which patients are loop diuretics most likely used?
Patients with both hypertension and edema due to heart failure.
p.9
Mechanisms of Action and Adverse Effects of Antihypertensive Drugs
Why are β-adrenoceptor blocking agents considered safer in asthma?
Because they can be selective and minimize bronchoconstriction.
p.11
Drug Classes for Hypertension Treatment
What class of drugs does Clonidine belong to?
Centrally Acting Adrenergic Drugs (α2 Agonists).
p.9
Mechanisms of Action and Adverse Effects of Antihypertensive Drugs
What receptors does Labetalol block?
α1, β1, and β2 receptors.
p.29
Mechanisms of Action and Adverse Effects of Antihypertensive Drugs
What condition can thiazides precipitate in susceptible individuals?
Gout, due to elevated serum uric acid levels.
