Treatments and Medications of Hypertension

 

The risk of cardiovascular disease starts to increase if a person’s blood pressure rises above 115/75 mm Hg (“High blood”). The blood pressure of Stage 1 hypertension ranges from 140-159/90-99 mm Hg, while the Stage 2 hypertension, the most serious hypertension, ranges from 160 mm Hg and above or a diastolic pressure of 100 mm Hg or above (“High blood”).

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Patients with isolated systolic hypertension have normal diastolic pressure but elevated systolic pressure. This type of hypertension is common among patients older than 50 (“High blood”). The doctor usually makes his or her diagnoses of hypertension after taking two to three blood pressure readings each at two or more separate clinic visits of the patient (“High blood”). The rationale for this is the condition known as white-coat hypertension wherein the blood pressure of the patient normally changes throughout the day and sometimes during appointments to the doctor (“High blood”). Because of this condition, the doctor may recommend to the patient to record his or her blood pressure readings at home and at work to provide additional data (“High blood”).

After diagnosing a patient with high blood pressure, the doctor may suggest to the patient to take a urine test, blood tests and an electrocardiogram (“High blood”). Hypertension, if not treated, can lead to heart attacks, strokes, kidney disease, or heart failure (“An overview”). The overall goal of treating hypertension is to lower high blood pressure and protect the patient’s important organs from damage (“An overview”). Immediate treatment of hypertension has been linked with average reduction in stroke by 35 percent to 40 percent, heart attack by 20 percent to 25 percent, and heart failure by more than 50 percent (“An overview”).

If the blood pressure of patients age 80 or older is very high, the doctor may establish a target goal of slightly greater than 140/90 mm Hg (“High blood”). All patients with blood pressure readings higher than 120/80 mm Hg are encouraged by doctor to change their lifestyle. Antihypertensive agents are recommended by doctor in order to lower blood pressure to below 140/90 mm Hg. The recommended blood pressure of patients with diabetes or chronic kidney disease is lower than 130/80 mm Hg (“An overview”).

Having a healthy lifestyle can help enhance the effectiveness of drug therapy for hypertension. It is also the most important step in preventing and treating hypertension. Lifestyle changes involve reducing weight if a patient is overweight or obese, quitting smoking, and eating healthier diet such as eating more vegetables, fruits, low fat dairy products, less saturated and total fat (“An overview”). Moreover, patients must also reduce the amount of sodium intake to 2,300 milligram or about 1 teaspoon of salt a day or less, getting a regular exercise such as brisk walking for at least 30 minutes a day, and limiting alcohol intake with two drinks a day for men and one drink a day for women (“An overview”).

There are several drugs can be used to treat high blood pressure or hypertension. These include angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers, thiazide diuretics, beta-blockers, renin inhibitors and calcium channel blockers (“High blood”).

Thiazide diuretics, also called water pills, are drugs that act on the patient’s kidneys to assist his or her body remove sodium and water, thus decreasing blood volume (“High blood”). Indapamide (Lozol), a special type of thiazide diuretic, is usually given to older patients because it has been claimed to decrease deaths from heart failure, stroke, and other cardiovascular disease causes (“High blood”).

Beta blockers can reduce the workload on the patient’s heart and open his or her blood vessels, causing his or her heart to beat slower and with less force and are effective to black patients when combined with thiazide diuretic (“High blood”). ACE inhibitors can help relax the patient’s blood vessels by stopping the formation of a natural chemical that constricts blood vessels (“High blood”). Angiotensin II receptor blockers can help relax blood vessels by stopping the action of a natural chemical that constricts blood vessels (“High blood”). ACE inhibitors and angiotensin II receptor blockers may be useful for hypertensive patients with coronary artery disease, heart failure or kidney failure (“High blood”).

Calcium channel blockers can help relax the muscles of the patient’s blood vessels and can slow his or her heart rate (“High blood”). Aliskiren (Tekturna), a type of renin inhibitors, can decelerate the production of renin, an enzyme produced by the kidneys that begins a series of chemical steps that increases blood pressure (“High blood”).

If the patient is having problem achieving the target blood pressure goal using the above drugs, the doctor may also prescribe alpha blockers and alpha-beta blockers to reduce nerve impulses to blood vessels, central-acting agents to prevent the brain from signaling the nervous system to increase the heart rate and constrict the blood vessels, and vasodilators to prevent the muscles in the walls of the arteries from tightening and the arteries from narrowing (“High blood”). The doctor may recommend nonthiazide diuretic drugs to patients with resistant hypertension (“High blood”).

The doctor may recommend giving two drugs if the patient’s blood pressure is more than 20/10 mm Hg higher than it should be (“An overview”). After a patient starts with hypertension drug therapy, it is advisable to see the doctor at least once a month until the target blood pressure goal is achieved (“An overview”). The doctor will examine the patient’s level of potassium on his or her blood and magnesium and BUN/creatinine levels at least once or twice a year (“An overview”). After the target blood pressure goal is attained, the patient should continue visiting his or her doctor every three to six months, depending on whether there are other existing diseases that are present such as heart failure (“An overview).

References

 

An overview of high blood pressure treatment. Retrieved July 25, 2009, from

http://www.webmd.com/hypertension-high-blood-pressure/guide/hypertension-treatment-overview

 

High blood pressure (hypertension): Tests and diagnosis. Retrieved July 25, 2009, from

http://www.mayoclinic.com/health/high-blood-pressure/DS00100/DSECTION=tests-and-diagnosis

High blood pressure (hypertension): Treatments and drugs. Retrieved July 25, 2009, from

http://www.mayoclinic.com/health/high-blood-pressure/DS00100/DSECTION=treatments-and-drugs

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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