1. MANAGEME
NT OF
HYPERTENSI
ON.
Vandana V.

2. Investigations
- Confirm the diagnosis
- Initial evaluation:
* Renal - microscopic urine analysis, urine albumin,
serum BUN and creatinine
* Endocrine - serum Na, K, Ca, TSH
* Metabolic - fasting blood glucose, total cholesterol,
HDL and LDL cholesterol, triglycerides
* Other investigations - hematocrit,
electrocardiogram

3. Treatment of hypertension
Lifestyle Interventions Pharmacologic therapy
Treatment Goals:
*S.B.P. <135-140 mm Hg
D.B.P. <80-85 mm Hg
*Patients with diabetes, Congestive heart disease,
chronic kidney disease and CVS risk factors:
< 130/80 mm Hg
*Patients with proteinuria(>1g/d):
S.B.P.~120mm Hg

4. Non-drug therapy:
Lifestyle interventions
Weight reduction: BMI < 25kg/m
Dietary salt reduction: <6g NaCl/d
DASH-type diet plan
Physical activity
Primary care
strategies:
To improve screening
and detection of
hypertension in affected
individuals
2

7. Pharmacologic Therapy
Compelling indications for the use of Anti-
hypertensive drugs:
1. Heart failure
2. High risk of coronary artery disease
3. Past h/o MI
4. Past h/o stroke
5. Diabetes
6. Chronic renal disease

8. Anti-hypertensive drugs
- Diuretics
- ACE inhibitors
- Angiotensin blockers/ AT1 receptor blockers
- Ca channel blockers
- B adrenergic blockers
- a adrenergic blockers
- a + B adrenergic blockers
- Central sympatholytics
- Vasodilators

9. Line of management
Restrict or remove Na+
Reduce mineralocorticoid
activity
- Diuretics
- ACE inhibitors
- Aldosterone blockers
Reduce heart rate and
contractility
- B blockers
- Sympatholytics
- Ca channel blockers
- Vasodilators
*Tumors of the JG apparatus/ Rennin producing tumors, tumors of zona
glomerulosa of adrenal gland (Conn’s syndrome) might need
chemotherapy, radiotherapy and surgical interventions.
*Renal artery stenosis (atheromatous plaques / fibromuscular dysplasia)
* Pregnancy, OCP use

10. THANK YOU