HTN- Less than 60, CKD or DM
Tx at 140/90
HTN > age 60
Tx 150/90
HTN w/ CKD
ACEI or ARB first line
HTN- black
Thiazide or CCB
HTN, nonblack
Thiazide, ACE or ARB, CCB
HTN- Sx
Asymptomactic, eye changes (papiliedema), loss of peripheral pulses
Primary aldosteronism
- Elevated aldosterone, suppression of renin
- Hypokalemia- weak, fatigue, palpitations
2nd HTN- CKD
- GFR decline, proteinuria
- Increase intravascular volume
2nd HTN- Renal artery stenosis
- Excess artery stenosis
- Renal bruits, avoid ace + arb
2nd HTN-Coarction of aorta
- Congenital narrowing of aortic arch
- Arm/ leg SBP > 20 mmhg
- Absent femoral pulses
2nd HTN-Pheochromochytoma
- Cathecholamine endocrine tumor
- Attacks triggered by exercise, bending, stress,
- Flushing, ortho htn, palpitations
- hypertensive crisis
2nd HTN-Cushings
- Excess salt & water - increased angiotensin
2nd HTN-Sleep apnea
CO2 causes anoxic events- daytime somnolence, snoring apnic events
Beta blockers- MOA
Antagonizes beta receptors, decreased HR and decreased vascular tone
Beta blockers- Names
- Olols
Alpha blockers- Names
- osin
Not commonly used
Alpha blockers- MOA
Promote vasodilation
Peripheral agents- Names
Guanthidine, Reserpine
- Used for refractory HTN
Peripheral agents- MOA
Blocks NE in periphery
Central alpha agonist- Names
Clonidine, methyldopa
Central alpha agonist- MOA
- Reduces peripheral sympathetic outflow, not used
- OK in pregnancy
Direct vasodilators
- Hydralazine, minoxidil
ACEI- Names
lisonoprils
-prils
ACEI- MOA
Inhibits RAAS pathway
- Dry cough, angioedema
