Jicama
Irelia: The Blade Dancer;
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ANTI-HYPERTENSIVE DRUGS
Pharmacology (Lecture)
Dr. Florencia Munsayac | March 12, 2021 | Topic 1
HYPERTENSION
Ø The most common cardiovascular disease
Ø The prevalence varies with age, race, education, and
many other variables.
Ø Sustained arterial hypertension damages blood
vessels in kidney, heart, and brain and leads to an
increased incidence of renal failure, coronary disease,
heart failure, stroke, and dementia.
Ø Effective pharmacologic lowering of blood pressure
has been shown to prevent damage to blood vessels
and to substantially reduce morbidity and mortality
rates.
Ø The diagnosis of hypertension is based on repeated,
reproducible measurements of elevated blood
pressure – a prediction of consequences for the
patient.
ETIOLOGY OF HYPERTENSION
A. Primary hypertension (85 – 90%)
- No specific causes
B. Secondary hypertension (10 – 15%)
- Renal artery constriction
- Coarctation of aorta
- Pheochromocytoma
- Cushing’s syndrome
- Primary aldosteronism
C. Contributing Factors:
- Genetic factors (30%)
- Mutations in several genes
- Functional variations of the genes for
angiotensinogen, ACE, the Angiotensin II
receptor, the beta2 adrenoceptor, alpha adducin
(a cytoskeletal protein)
- Psychological stress
- Environmental factors
- Dietary factors (increased salt and decreased
potassium and calcium intake)
EFFECTS OF HYPERTENSION
Ø Worldwide: 1.13 billion, 2/3 living in low- and middle-
income countries.
Ø In 2015: 1 in 4 men and 1 in 5 women had
hypertension.
Ø Hypertension is a major cause of premature death
worldwide.
Ø One of the global targets for non-communicable
diseases is to reduce the prevalence of hypertension
by 25% by 2025 (baseline 2010).
Ø Incidence of CVD in the Philippines showed
hypertension as the highest (38.6%), followed by
stroke (30%), coronary artery disease (CAD) (17.5%),
and heart failure (10.4%).
NORMAL REGULATION OF HYPERTENSION
Ø ABP = CO x TPR
Overview
I. Hypertension
II. Etiology of Hypertension
III. Effects of Hypertension
IV. Normal Regulation of Hypertension
V. Diagnosis and Manifestations of
Hypertension
VI. Management of Hypertension
VII. Classification of Anti- hypertensive Drugs
a. Diuretics
b. Centrally- Acting Agents
c. Beta- Adrenergic Receptor Antagonists
d. Alpha- Adrenergic Antagonists (a1)
e. Non- selective Alpha- Adrenergic
Antagonists
f. Vasodilators
i. Hydralazine
ii. Diazoxide
iii. Minoxidil
iv. Fenoldopam
v. Calcium Channel Blockers
(CCBs)
g. Angiotensin- Converting Enzyme
Inhibitors (ACEIs)
h. Angiotensin II Receptor Antagonists
(ARBs)
i. Renin Inhibitors
j. Endothelin Receptor Antagonists
