Professional Documents
Culture Documents
Pharmacotherapy of Hypertension 2
Pharmacotherapy of Hypertension 2
Pharmacotherapy of Hypertension 2
Hypertension
Defined as:
&
JNC 8 Recommendation
Strategy Description
A Start one drug, to maximum dose, and then
add a second drug.
B Start one drug, then add a second drug
before achieving max dose of first.
C Begin 2 drugs at same time, as separate pills
or combination pill. Initial combination
therapy is recommended if BP is greater
than 20/10mm Hg above goal.
JNC 8 Hypertension Guideline Algorithm
Complications of hypertension:
Myocardial infarction
Stroke
Cerebral/brainstem infarction
Cerebral haemorrhage
Lacunar syndromes
Multi infarct disease
Hypertensive encephalopathy/ malignant hypertension
Dissection aortic aneurysm
Hypertensive nephroscelrosis
Peripheral vascular disease
Epidemiology
10-25% population are expected to benefit from the drug treatment
Genetic factors also clearly plays a role, but not a single gene is responsible
for hypertension except in Polycystic kidney disease /Liddle’s syndrome
Contributing factors:
Pharmacological approaches
• DASH- fruit, vegetables, low fat dairy products, fish, low fat poultry
and whole grains, minimizing red meat, confectionary and sweetened
drinks
• Subjects should reduce their salt intake (6g NaCl)
• Significant hidden salt in the processed meat, ready meals, cheese and even
bread
A+C or A+D
A+C+D