Vascular problems part 1

Effects all races

African American males- may not take BB because of impotence (per ED), HCP bias, Can be pricy

Normal BP Sys:<120, and, Dias:<80, Elevated BP Sys: 120-129, and, Dias: <80, High BP stage 1 Sys: 130-139, or, Dias: 80-89, High BP stage 2 Sys: 140 or higher, or, Dias 90 or higher, Hypertensive crisis consult dr immediately Sys: higher than 180, and/or Dias: Higher than 120

Elevation despite treatment with 3 or order antihypertensices at max dose!, Urgency Sys:180, and or Dias:>120, Emergency Sys:>180 + target organ damage and or Dias:>120 +target organ damage

Sense pressure changes

Retention or diuresis

Activation causes Na & H2O retention

Vascular auto-regulation

No known cause, RF: age, RF: Family hx, AA ethnicity, RF: Obesity, inactivity, RF: Smoking, RF: Stress, RF: Alcohol, caffeine, Na, RF: low Ca, mg,K

Kidney or adrenal disease #1, Aortic narrowing #2, Brain disease, OSA, Estrogen, steroids, Sympathomimetics, Foods

Healthy lifestyle choices, Yearly checks

Healthy lifestyle changes, Reassessed in 3-6 months

10-year heart disease and stroke assessment, If less than 10% risk, life style changes reassess in 3-6 months, If higher than 10% risk lifestyle changes, meds with monthly follow-ups until BP controlled

Lifestyle changes, 2 different classes, monthly follow ups until controlled

Deficient Knowledge, Risk for ineffective therapeutic regimen management

DASH diet, Moderate ETOH, Smoking cessation, Exercise -dynamic aerobic -dynamic resistance -isometric, Complementary therapies i.e. yoga

Diuretics, Ca channel blockers, ACE-I and ARBs, Alpha blockers & central alpha blockers, B blockers, Adrenergic blockers, Direct vasodilators, Direct renin inhibitors

Ok great thanks

Prevents Na &H2O reabsoprtion in the distal tubules, Increases K+ excretion, Caution/SE: Gout, hyponatremia, bipolar disorder

Teach K+ replacement, Teach can ⬆️ BS if disabtic, Chlorothiazide (Diuril), Chlorothalidone (hygrton)**, Hyrocholorothiazide (hydroDIURIL), Metolazone (Zaroxolyn, “thiazide”

Inhibits Na reabsoprtion in the loop of henle, Promotes K+ excretion, SE: Hypokalemia, SE: Dehydration, SE: Frequent voiding

Furosemide (lasix) (1 of the biggest replace K+ and monitor), Bumetanide (Bumex)(1 of the biggest replace K+ and monitor), Torsemide (Demadex), Ethacrynic acid (Edecrin), “ide”

Prevents reabsoprtion of NA in distal tubules while retaining K+, Frequenly given in combination with K+ depleting

Hyperkalemia, Amiloride (midamor), eplerenon(inspiration), **Spirnolactone (aldactone)**, Triamterene (Dyrenium)

Causes smooth muscle relaxation by blocking Ca bonding, SE hypotension, SE bradycardia, SE possibly edema, Amlodipine (norvasc)*, Felodipine (Plendil), Nicardipine (Cardene), NOTE: other CCB will effect BP but primary use is for non-ventricular tachycardias or angina treatment, “pine”

Blocks conversion angiotensin 1 to angiotensin 2, Cause peripheral arterial and venous vasodilation decrease SVR, Possible improved diastolic function, Probable rescued loss of myocardial cells, SE low BP, SE worsening kidney function, SE hyperkalemia, SE chronic cough

“pril”, Enalpril (Vasotec), Captopril (Capoten), Lisinopril (Zestril), Quinapril (Accupril)

block angiotensin receptors, impairing the action of circulation angiotensin 2, Used when ACE not tolerated, Shoulde not be considered equivalent or superior to ACE-Is, Pregnancy category D, Hypotension, N,V,D

“spartan”, Losartan (Cozaar), Valsartan (Diovan), Candesartan (Atacand)

Blocks ecessive SNS stimulation, Decr4ease HR and contractility which lowers systemic BP, Block beta receptors which inhibits secretion of renin, Hypotension, Bradycardia, Fluid rention, Fatigue, Impotence, Masks hypoglycemia in DM

“olol”, metoprolol (lopressor, toprol XL), carvedilol (Corey, labetolol (normodyne, trandate), propranolol (inderal)

All of the above