Antihypertensive drugs treatment

Ram CV. Direct renin inhibitors a new approach to antihypertensive drug treatment. J Cfin Hypertens (Greenwich) 2007 9(8) 615-21. 

SHEP Co-operative Research Group Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension final results of the Systolic Hypertension in the Elderly Programme (SHEP). JAMA 1991 265 3255-64. 

There is evidence that a healthy diet, regular exercise and moderation of alcohol intake can reduce, delay or remove the need for long-term antihypertensive drug treatment (North of England Hypertension Guideline Development Group, 2006). 

SHEP Cooperative Research Group. Prevention of stroke by antihypertensive drug treatment in older... 

Collins R, MacMahon S. Blood pressure, antihypertensive drug treatment and the risks of stroke and of coronary heart disease. Br Med Bull 1994 50(2) 272-98. 

Primary aldosteronism was first described by Conn in 1955 and is characterized by an elevated plasma concentration of aldosterone along with hypertension and hypokalemia. Because <1% of hypertensive patients have primary aldosteronism, indications that should lead to further evaluation include hypokalemia that is unprovoked by diuretics or the lack of response to conventional antihypertensive drug treatment. Overproduction of aldosterone may be due to an... 

The most frequent adverse effect of epoetin is an increase in blood pressure, so it is important to control any existing hypertension before epoetin is started (the manufacturers contraindicate epoetin in uncontrolled hypertension). Blood pressure should be monitored before and during epoetin treatment, and if necessary antihypertensive drug treatment should be started or increased if the pressure rises. 

If the person has severe hypertension, consider starting antihypertensive drug treatment immediately, without waiting for the results of ambulatory or home blood pressure monitoring. 

Condnsion The current evidence does not support the need to treat moderate arterial hypertension aggressively perioperatively, but supports continued medication when possible unless clinical circumstances dictate otherwise. Most of the evidence for starting antihypertensive drug treatment relates to risk modification in patients at high cardiovascular risk. Many... 

Finally, drug treatment in the elderly is of great importance and warrants special attention with regard to safety and tolerability, since systolic blood pressure is recognized as an important target for treatment, particularly in older persons. The benefits of antihypertensive treatment in the elderly and in patients with isolated systolic hypertension are greater than in younger persons. 

As a consequence for drug treatment, an increasing number of patients will be treated with antihypertensive... 

VMATs are irreversibly inhibited by the potent antihypertensive drug reserpine. The depressive effects of reserpine helped to formulate the original monoamine hypothesis of affective disorders. Reseipine also appears to interact with the transporters near the site of substrate recognition. Tetrabenazine, which is used in treatment of movement disorders, inhibits VMAT2 much more potently than VMAT1, consistent with the less hypotensive action of this agent. 

Antihypertensives are used in the treatment of hypertension. Although many antihypertensive drugs are available, not all drag may work equally well in a given patient. In some instances, the primary care provider... 

To ensure lifetime compliance with the prescribed therapeutic regimen, the nurse emphasizes the importance of drug therapy, as well as other treatments recommended by the primary care provider. The nurse describes the adverse reactions that may be seen with a particular antihypertensive drug and advises the patient to contact the primary care provider if any should occur. 

Mr. Bates, who has been treated for hypertension, is admitted for treatment of a kidney done On admission, he had severe pain and his blood pressure was 16006 mm Hg. For the past 2 days, his blood pressure has been between 14002 and 14802 mm Hg. When taking his blood pressure before givijTg him an oral antihypertensive drug, you find that it now is 11802 mm Hg. A nalyze the situation and discuss what actions you would take... 

Diuretics are used in a variety of medical disorders. The primary health care provider selects the type of diuretic diat will most likely be effective for treatment of a specific disorder. In some instances, hypertension may be treated with the administration of an antihypertensive drug and a diuretic. The diuretics used for this combination tiierapy include the loop diuretics and the thiazides and related diuretics. The specific uses of each type of diuretic drug are discussed in the following sections. 

Clearly, the ideal antihypertensive drug will be one which neutralizes a specific etiological factor responsible for the disease. Unfortunately, a specific etiology has not been found for the overwhelming number of hypertensive states in man. It is also becoming apparent that numerous factors regulate the blood pressure and that, therefore, numerous variables may be deranged in hypertension(6). Thus, an empirical approach is still necessary in the treatment of the hypertensive patients. 

Synthetic guanidine derivatives have been used successfully in the treatment of a variety of diseases, but the major success has undoubtedly been their exploitation as antihypertensive drugs. Guanethidine has still not been displaced. 

Depending on the severity of the hypertension, treatment with antihypertensive drugs proceeds strategically in a specific order. It is understood that this order should be flexible and open to alternative ways, but a few general principles must be adhered to. 

Minoxidil is a peripheral vasodilator that directly relaxes vascular smooth musculature, thus, lowering systolic and diastolic pressure. Its action is linked to the activation of calcium channels. Open calcium channels cause hyperpolarization of smooth muscle cells, which in turn, reduces the flow of calcium ions into the cell, which is necessary for supporting vascular tonicity. However, when taking minoxidil, tachycardia, elevated renin secretion, and water and sodium ion retention all appear simultaneously with hypotension. Because of potentially serious side effects, it is used only for severe hypertension that does not respond to treatment with other drugs, and absolutely in combination with two other antihypertensive drugs. A synonym of this drug is loniten. 

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