2.

Hypertension (HT)
• A sustained elevation of systolic and/or diastolic BP above an
arbitrarily defined level
(systolic >139 mmHg and/or diastolic >89 mmHg)

 Primary (essential) HT is a lifelong disease, needs long-term control

& treatment
 Secondary HT may be cured by surgical procedures (early diagnosis
of cause)
3. Classification of Hypertension (HT)
3.1. Based on severity
systolic (mmHg) diastolic (mmHg)
• Normal <120 and < 80
• Pre-hypertension 120 - 139 or 80 - 89
• Stage 1 Hypertension 140 -159 or 90 - 99
• Stage 2 Hypertension >160 or >100
• 3.2.2. Primary (essential) HTs (> 90%)
• primary cause(s) unknown, possibly multi-factorial defects
genetics
smoking
caffeine
stress
salt intake
alcohol
obesity
Age and others
3.2. Based on pathogenesis

3.2.1. Secondary HTs (< 10%)

• neurogenic HT caused by brain damage
• cortisol overproduction: hypophysis or adrenal gland tumor
• aldosterone overproduction: adrenal gland tumor hyperplasia
• renal artery stenosis or occlusion
• adrenal medullary tumor: pheochromocytoma
ANTIHYPERTENSIVE DRUG

• An agent that reduces high blood pressure is

called as an ANTIHYPERTENSIVE DRUG
CLASSIFICATION OF DRUGS
1. ACE INHIBITORS
• Captopril, Enalapril, Lisinopril, Ramipril.

2. ANGIOTENSIN ANTAGONISTS
• Losartan, Irbesartan, Candesartan

3. CALCIUM CHANNEL BLOCKERS

• Nifedipine, Felodipine, Amlodipine, Lacidipine,
4. DIURETICS
• Thiazide= Hydrochlorothiazide, Chlorthalidone, Indapamide
• High ceiling = Furosemide
• K+ sparing = Spironolactone, Amiloride,

5. CENTRAL SYMPATHOLYTIC
• Clonidine, Methyldopa

6. VASODILATORS
• Hydralazine, Minoxidil sodium
7. α - ADRENERGIC BLOCKERS
• Prazosin, Terazosin, Phentolamine

8. ß - ADRENERGIC BLOCKERS
• Propranolol, Metaprolol, Atenolol.

9. α+ß ADRENERGIC BLOCKERS

• Labetalol, Carvedilol.
ACE INHIBITORS M/A
Mechanism of Action of Propranolol
Mechanism of Action of Propranolol

Vasomotor refers
to actions upon a
blood vessel which
alter its diameter.
More specifically, it
can refer to
vasodilator action
and
vasoconstrictor
action
Mechanism of Action of Propranolol
Physiology
1. Blood Pressure Regulation:

• Frank's formula, BP regulation:

BP = CO x TPR CO = HR x SV
• Baroreceptor reflex:
oppose changes in BP,
rapid, moment-to-moment BP adjustments
• Renal system:
Control of Na and H2O balance,
responsible for long-term BP control
Item questions
• Define Hypertension. Write the types of HTN .
• What are the risk factor for HTN, Essential Causes of Hypertension
• Define Anti hypertensive drugs. Name some anti HTN drugs.
• Classify anti hypertensive drugs.
• Indication, Side effects / Complications of anti HTN drugs
• How antihypertensive drugs regulate the BP?
• Name ACE inhibitors and their M/A
• Name some Cardio selective Beta Blocker. How does Beta Blocker
lower the Blood pressure