Blood pressure, elevated

Treatment of essential or primary hypertension emphasizes not only the lowering of the elevated blood pressure, but also individualized therapy for each patient, providing each patient with minimized unnecessary side effects. The patient s cardiovascular morbidity and mortaUty should be decreased and end organ damage reversed or reduced (184,185). 

ACE inhibitors lower the elevated blood pressure in humans with a concomitant decrease in total peripheral resistance. Cardiac output is increased or unchanged heart rate is unchanged urinary sodium excretion is unchanged and potassium excretion is decreased. ACE inhibitors promote reduction of left ventricular hypertrophy. 

Indapamide has been shown to possess diuretic and iadependent vasodilatory effects (16). It lowers the elevated blood pressure and reduces total peripheral resistance without an iacrease ia heart rate. ladapamide antagoni2es the vasocoastrictiag effects of the catecholamiaes and angiotensin II (16), a property not shared by other thia2ide-type diuretics. Tripamide is also reported to have direct vasodilatory effects (13). 

Elevated blood pressure (white males, aged 40-59)... 

Atherosclerosis is a degenerative disease which is characterized by cholesterol-containing thickening of arterial walls. Saturated fatty acids, high levels of cholesterol, elevated blood pressure, and elevated serum lipoprotein are well-knowm risk... 

Hyperlipidemia. Elevated lipid levels in the blood. Hypertension. Elevated blood pressure. 

The direct target for Rho. The enzyme is inhibited by Y-27632, a compound that lowers elevated blood pressure in animal models of hypertension. 

A compound that lowers elevated blood pressure by inhibition of Rho-kinase. 

Another type of antihypertensive drug is the diuretic. The mechanism by which the diuretics reduce elevated blood pressure is unknown, but it is thought to be based, in part, on their ability to increase the excretion of sodium from the body. The actions and uses of diuretics are discussed in Chapter 46. 

Severely elevated blood pressure without acute end-organ damage... 

A 73-year-old man with a history of diabetes mellitus, chronic kidney disease, gout, osteoarthritis, and hypertension is hospitalized with possible urosepsis. He recently completed a 10-day course of antibiotics and was ready for discharge when his morning labs showed an increase in BUN and serum creatinine concentration. Upon examination, he was found to have 2+ pitting edema, weight gain, nausea, elevated blood pressure, and rales on chest auscultation. 

Progression factors can be used as predictors of CKD. The most important predictors of CKD include proteinuria, elevated blood pressure, hyperglycemia, and tobacco smoking. 

What are some treatment options, in addition to metoprolol 100 mg twice daily and amlodipine 10 mg daily, for JJ s elevated blood pressure ... 

Common adverse reactions seen with phentermine use include heart palpitations, tachycardia, elevated blood pressure, stimulation, restlessness, dizziness, insomnia, euphoria, dysphoria, tremor, headache, dry mouth, constipation, and diarrhea. Phentermine should be avoided in patients with unstable cardiac status, hypertension, hyperthyroidism, agitated states, or glaucoma. In combination with fenfluramine or dexfenfluramine, pulmonary hypertension and valvular heart disease have been reported. The risk of developing either serious adverse effect cannot be ruled out with use of phentermine alone. Since phentermine is related to the amphetamines, the... 

Use of diethylpropion for a period longer than 3 months is associated with an increased risk for development of pulmonary hypertension. When used as directed, reported common central nervous system adverse effects included overstimulation, restlessness, dizziness, insomnia, euphoria, dysphoria, tremor, headache, jitteriness, anxiety, nervousness, depression, drowsiness, malaise, mydriasis, and blurred vision. In addition, diethylpropion can decrease seizure threshold, subsequently increasing a patient s risk for an epileptic event. Other organ systems also can adversely be affected, resulting in tachycardia, elevated blood pressure, palpitations, dry mouth, abdominal discomfort, constipation,... 

Sethi AA, Nordestgaard BG, Ager-holm-Larsen B, Frandsen E, Jensen G, Tybjaerg-Hansen A. Angiotensinogen polymorphisms and elevated blood pressure in the general population - the Copenhagen City Heart study. Hypertension 2001 37 875-881. 

Sibutramine use also carries the risk of side effects, which include elevated blood pressure, increased heart rate, dry mouth, nausea, and dizziness. Abuse of sibutramine can cause dilated pupils, excessive bleeding or bruising, tremor, and anxiety. As with all prescription drugs, it is essential to use sibutramine according a doctor s instructions. The alternative is the possibility of unpleasant side effects and dangerous outcomes. 

Art 83-year-old male has been effectively treated with hydrochlorothiazide to control his elevated blood pressure. He has had a recent onset of weakness. Blood chemistry analysis reveals a K+ of 2.5 mEq/L. Another drug is added, and one month later his serum K7 is 4.0 mFq/L. 

Thiazide diuretics (e.g., hydrochlorothiazide) are relatively weak diuretics and are used alone infrequently in HF. However, thiazides or the thiazide-like diuretic metolazone can be used in combination with a loop diuretic to promote effective diuresis. Thiazides may be preferred over loop diuretics in patients with only mild fluid retention and elevated blood pressure because of their more persistent antihypertensive effects. 

Elevated blood pressure should remain untreated in the acute period (first 7 days) after ischemic stroke because of the risk of decreasing cerebral blood flow and worsening symptoms. The pressure should be lowered if it exceeds 220/120 mm Hg or there is evidence of aortic dissection, acute myocardial infarction, pulmonary edema, or hypertensive encephalopathy. If blood pressure is treated in the acute phase, short-acting parenteral agents (e.g., labetalol, nicardipine, nitroprusside) are preferred. 

Elevated blood pressure is common after ischemic stroke, and its treatment is associated with a decreased risk of stroke recurrence. The Joint National Committee and AHA/ASA guidelines recommend an angiotensin-converting enzyme inhibitor and a diuretic for reduction of blood pressure in patients with stroke or TIA after the acute period (first 7 days). Angiotensin II receptor blockers have also been shown to reduce the risk of stroke and should be considered in patients unable to tolerate angiotensinconverting enzyme inhibitors after acute ischemic stroke. 

Buspirone may increase haloperidol levels and elevate blood pressure in patients taking a monoamine oxidase inhibitor (MAOI). 

Withdrawal symptoms include mental status changes, tremors, elevated blood pressure, tachycardia, tremors, and severe agitation. BZs may be useful to control agitation. 

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