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S.G.R.R.I.T.S.
Hypertension is a very
common disorder, particularly
past middle age. It is not a
disease in itself.
LIST OF ABBREVIATIONS
Abbreviations Description
ACE Angiotension 2nd converting
enzyme
CCB Calcium channel blocker
ARB Angiotension receptor blocker
The normal level for blood pressure is below
120/80, where 120 represent the systolic
measurement and 80 represents the diastolic
measurement . Blood pressure between
120/80 and 139/89 is called pre hypertension
(to denote increased risk of hypertension), and
a blood pressure of 140/90 or above is
considered hypertension.
Hypertension may be classified as
1.Essential
2.Secondary.
Essential hypertension is the
term for high blood pressure with unknown
cause. It accounts for about 95% of cases.
Secondary hypertension is the term for
high blood pressure with a known direct
cause, such as kidney disease, tumors,
or birth control pills.
What causes hypertension?
1.Smoking ,overweight
2.Diabetes
3.Lack of physical activity
4.Insufficient calcium, potassium and
magnesium consumption
5. Vitamin D deficiency
6.High levels of alcohol consumption
7.Aging
8.Medicines such as birth control pills
How Does Smoking Increase Heart Disease Risk?
The nicotine present in tobacco products causes:
1.Decreased oxygen to the heart
2.Increased blood pressure and
heart rate
3.Increase in blood clotting
Classification of antihypertension drugs-
A. Diuretics-
1.Loop diuretics
 bumetanide
 ethacrynic acid
 furosemide
 torsemide
2.Thiazide diuretics
 epitizide
 Hydrochlorothiazide
and chlorothiazide
bendroflumethiazi
de
3.Thiazide-like
diuretics
 indapamide
 chlorthalidone
 Metolazone
4.Potassium-sparing
diuretics
 amiloride
 triamterene
B.Adrenergic receptor antagonists
1.Beta blockers
 atenolol ,metoprolol
 nadolol
 nebivolol
 oxprenolol
 pindolol
 Propranolol
 timolol
2. Alpha blockers
 doxazosin
 indoramin
 phenoxybenzamine
 Prazosin
 terazosin
 tolazoline
3.Mixed Alpha + Beta blockers
 bucindolol
 carvedilol
 labetalol
C. Calcium channel blockers
1.dihydropyridines
 amlodipine
 felodipine
 isradipine
 lercanidipine
 nicardipine
 nifedipine
 nimodipine
 Nitrendipine
2.non-dihydropyridines
 diltiazem
 verapamil
D.ACE inhibitors
 captopril
 enalapril
 fosinopril
 lisinopril
 perindopril
 quinapril
 ramipril
 trandolapril
 benazepril
E. Angiotensin II receptor
antagonists
 candesartan
 eprosartan
 irbesartan
 losartan
 olmesartan
 telmisartan
 valsartan
F. Aldosterone antagonists
 eplerenone
 spironolactone
Commonly Used Oral Antihypertensive Medications
Class Generic Daily Common Tablet
Name Dose Name Size
(mg) Brand (mg)
(s)
Diuretics Hydrochloro 12.5-50 Hydrex 25
thiazide
Aldactazide 25
Moduretic 25
Indapamide 1.25-5 Natrilix 2.5
Natrilix SR 1.5
Frusemide 20-400 Lasix 40
Class Generic Daily Common Tablet
Name Dose Name Size
(mg) Brand (mg)
Beta
Adrenergic
blockers Atenolol 25-100 Tenormin 50, 100
Blockium 50, 100
Blockium Diu * 50
Metoprolol 50-200 Betaloc 100
Bisoprolol 2.5-10 Concor 5,10
Concor 5 Plus* 5
Class Generic Daily Common Tablet
Name Dose Name Size
(mg) Brand (mg)
ACE
Inhibitors Captopril 50-150 Capoten 25, 50
Capozide * 50
Captopril 25, 50
Enalapril 2.5-40 Renetec 10, 20
Co-renetec 10,20
Ezapril 10,20
Lisinopril 10-40 Zestril 5,10,20
Zestoretic 20
Ramipril 2.5-20 Tritace 1.25, 2.5, 5,
Tritace comp * 5
Tritace comp LS * 2.5
INITIAL
DRUG
THERAPY
No
compelling
indications
Stage 1st
hypertensio
n
Stage 2nd
hypertensio
n
Compelling
indication
Thiazide type
diuretics ACE
inhibitor, ARE OR
Combination
Two drug
combination
usually thiazide
diuretics+ACE
inhibitor
Treatment-
Left
ventricular
function
Coronary
disease
Compelling
indication
Recurrent
stroke
prevention
Diabetes
mellitus
Post
myocardial
interaction
Chronic
kidney
disease
Diuretic with
ACE inhibitor
then add B-
blocker
B-blocker
then add
ACE
inhibitor
B- blocker
then add
ACE
inhibitor
ACE
inhibitor
diuretics
ACE
inhibitor
& ARB
CCB
diureticsAldosterone
antagonist
ARB or
aldosterone
antagonist
Diuretic
with ACE
inhibitor
B-
blockers
THANK YOU

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Passa2

  • 2. Hypertension is a very common disorder, particularly past middle age. It is not a disease in itself.
  • 3. LIST OF ABBREVIATIONS Abbreviations Description ACE Angiotension 2nd converting enzyme CCB Calcium channel blocker ARB Angiotension receptor blocker
  • 4. The normal level for blood pressure is below 120/80, where 120 represent the systolic measurement and 80 represents the diastolic measurement . Blood pressure between 120/80 and 139/89 is called pre hypertension (to denote increased risk of hypertension), and a blood pressure of 140/90 or above is considered hypertension.
  • 5.
  • 6. Hypertension may be classified as 1.Essential 2.Secondary. Essential hypertension is the term for high blood pressure with unknown cause. It accounts for about 95% of cases. Secondary hypertension is the term for high blood pressure with a known direct cause, such as kidney disease, tumors, or birth control pills.
  • 7.
  • 9. 1.Smoking ,overweight 2.Diabetes 3.Lack of physical activity 4.Insufficient calcium, potassium and magnesium consumption 5. Vitamin D deficiency 6.High levels of alcohol consumption 7.Aging 8.Medicines such as birth control pills
  • 10. How Does Smoking Increase Heart Disease Risk? The nicotine present in tobacco products causes: 1.Decreased oxygen to the heart 2.Increased blood pressure and heart rate 3.Increase in blood clotting
  • 11. Classification of antihypertension drugs- A. Diuretics- 1.Loop diuretics  bumetanide  ethacrynic acid  furosemide  torsemide 2.Thiazide diuretics  epitizide  Hydrochlorothiazide and chlorothiazide bendroflumethiazi de 3.Thiazide-like diuretics  indapamide  chlorthalidone  Metolazone 4.Potassium-sparing diuretics  amiloride  triamterene
  • 12. B.Adrenergic receptor antagonists 1.Beta blockers  atenolol ,metoprolol  nadolol  nebivolol  oxprenolol  pindolol  Propranolol  timolol 2. Alpha blockers  doxazosin  indoramin  phenoxybenzamine  Prazosin  terazosin  tolazoline 3.Mixed Alpha + Beta blockers  bucindolol  carvedilol  labetalol
  • 13. C. Calcium channel blockers 1.dihydropyridines  amlodipine  felodipine  isradipine  lercanidipine  nicardipine  nifedipine  nimodipine  Nitrendipine 2.non-dihydropyridines  diltiazem  verapamil D.ACE inhibitors  captopril  enalapril  fosinopril  lisinopril  perindopril  quinapril  ramipril  trandolapril  benazepril
  • 14. E. Angiotensin II receptor antagonists  candesartan  eprosartan  irbesartan  losartan  olmesartan  telmisartan  valsartan F. Aldosterone antagonists  eplerenone  spironolactone
  • 15. Commonly Used Oral Antihypertensive Medications Class Generic Daily Common Tablet Name Dose Name Size (mg) Brand (mg) (s) Diuretics Hydrochloro 12.5-50 Hydrex 25 thiazide Aldactazide 25 Moduretic 25 Indapamide 1.25-5 Natrilix 2.5 Natrilix SR 1.5 Frusemide 20-400 Lasix 40
  • 16. Class Generic Daily Common Tablet Name Dose Name Size (mg) Brand (mg) Beta Adrenergic blockers Atenolol 25-100 Tenormin 50, 100 Blockium 50, 100 Blockium Diu * 50 Metoprolol 50-200 Betaloc 100 Bisoprolol 2.5-10 Concor 5,10 Concor 5 Plus* 5
  • 17. Class Generic Daily Common Tablet Name Dose Name Size (mg) Brand (mg) ACE Inhibitors Captopril 50-150 Capoten 25, 50 Capozide * 50 Captopril 25, 50 Enalapril 2.5-40 Renetec 10, 20 Co-renetec 10,20 Ezapril 10,20 Lisinopril 10-40 Zestril 5,10,20 Zestoretic 20 Ramipril 2.5-20 Tritace 1.25, 2.5, 5, Tritace comp * 5 Tritace comp LS * 2.5
  • 18. INITIAL DRUG THERAPY No compelling indications Stage 1st hypertensio n Stage 2nd hypertensio n Compelling indication Thiazide type diuretics ACE inhibitor, ARE OR Combination Two drug combination usually thiazide diuretics+ACE inhibitor Treatment-
  • 19. Left ventricular function Coronary disease Compelling indication Recurrent stroke prevention Diabetes mellitus Post myocardial interaction Chronic kidney disease Diuretic with ACE inhibitor then add B- blocker B-blocker then add ACE inhibitor B- blocker then add ACE inhibitor ACE inhibitor diuretics ACE inhibitor & ARB CCB diureticsAldosterone antagonist ARB or aldosterone antagonist Diuretic with ACE inhibitor B- blockers