- Hypertension
- Hypertension Causes
- Hypertension Evaluation
- Hypertension Evaluation History
- Evaluation Exam
- Hypertension Evaluation Labs
- Isolated Systolic Hypertension
- Hypertension Management
- Hypertension Risk Stratification
- Resistant Hypertension
- Antihypertensive Selection
- Hypertension Management for Specific Comorbid Diseases
- Hypertension Management for Specific Emergencies
- Hypertension in Children
- Hypertension in Infants
- Hypertension in Pregnancy
- Hypertension in Athletes
- Hypertension in the Elderly
- Young Hypertensive
- Pathophysiology
- Active
- Increased sympathetic tone
- Elevated Plasma Renin Activity (PRA)
- First choice medications
- Other medications
- Beta-alpha Antagonist
- Alpha-1 Antagonist
- Calcium Channel Blocker
- Avoid
- Beta Blockers
- Decreased HDL
- Sexual activity and Exercise affected
- Beta Blockers
- Athletes
- Elderly
- See Hypertension in the Elderly
- Non-black patients over age 60 years old
- Black
- Pathophysiology
- Low renin
- High plasma volume
- High vessel resistance
- First Choice Medications
- Diuretics (Hydrochlorothizides)
- Concurrent use improves Beta Blocker response
- Concurrent use improves ACE Inhibitor response
- Calcium Channel Blockers
- Diuretics (Hydrochlorothizides)
- Changes (Previously contraindicated)
- ACE Inhibitors
- ACE Inhibitors are effective in black patients when added to Diuretics or Calcium Channel Blockers
- Previously thought not useful with low renin status
- Use if indicated for renal protection (however, will require additional Antihypertensive)
- AASK study showed benefit with Ramipril
- Retarded renal disease progression
- Wright (2002) JAMA 288:2421-31 [PubMed]
- ACE Inhibitors
- Other Medications
- Labetalol
- Hydralazine 37.5 mg with Isordil 20 mg three times daily
- Consider in NYHA Class 3-4 Heart Failure with Reduced Ejection Fraction
- Added as adjunct to ACE Inhibitor and Beta Blocker
- See Systolic Dysfunction
- Obesity (even 10 pounds or 4.5 kg over Ideal Weight)
- Pathophysiology
- Modestly elevated vessel resistance
- Higher Cardiac Output
- High plasma volume
- Low renin
- First Choice Management