Cardiovascular Therapeutics Flashcards
(15 cards)
What is hypertension?
Persistently raised arterial blood pressure
What are some modifiable risk factors for hypertension?
Smoking
Physical inactivity
Diet and weight
Diabetes
Stress
What are some non-modifiable factors for hypertension?
Age/Sex
Family history
Race/ethnic background
What are the types of hypertension?
Primary and Secondary
Why is clinic BP insufficient for a diagnosis of hypertension?
White coat hypertension
Elevated BP readings in a clinical setting, but normal BP outside.
What are the diagnosed stages of hypertension?
Stage 1 hypertension
Clinical blood pressure ranging from 140/90 to 159/99
Stage 2 hypertension
Clinical blood pressure ranging from 160/100 or higher
Stage 3 hypertension
Clinic systolic blood pressure 180
Hypertension drug treatment strategy
If their hypertensive - No antihypertensive
If they are not hypertensive, we check if their type 2 diabetic or not?
If yes, we treat them with ACEi or ARB
If not, we check their ethnicity.
If they are of a black African or black Caribbean background, we treat them with CCB
If they are not of the ethnic background mentioned above, then we check their age.
If they are 55 and over, we treat with CCB, and if they are under 55 we treat with ARB or ACEi
What can modulate peripheral resistance and blood pressure?
Vasodilation and vasoconstriction
What does baroceptor do?
Signals to the brain to regulate blood pressure via the autonomic nervous system.
What is the mechanism of noradrenaline-evoked vasoconstriction.
Noradrenaline binds to α₁-adrenergic receptor.
Activates Gq protein.
Stimulates PLC → IP₃ + DAG
IP₃ releases Ca²⁺ from SR
Ca²⁺ activates MLCK → myosin phosphorylation
Vasoconstriction occurs
Mechanism of action of alpha blocker in the management of hypertension
Block the action of the sympathetic nervous system (noradrenaline) on resistance arteries, causing vasodilation and reducing BP.
Mechanism of action of calcium channel blockers in the management of hypertension
Block L-Type VGCC
Clinically divided into two; dihydropyridines and rate limiting CCBs
Why may rate-limiting CCBs be preferred over dihydropyridine CCBs to some patients?
These may be preferred to dihydropyridine calcium-channel blockers in people with angina when a beta-blocker is contraindicated or not tolerated.
Mechanism of action of ARBs in the management of hypertension
Block action of angiotensin II on AT1-receptor
Mechanism of action of ACE inhibitors in the management of hypertension
Inhibit conversion of angiotensin I to angiotensin II
