HYPERTENSION-Treatment and Lifestyle modifications

Edited by, SRIRAM

Read about Hypertension-Etiology, complications, Pathophysiology, Clinical manifestations and Diagnosis- CLICK HERE 

PHARMACOLOGICAL TREATMENT:

There are several classes of Anti-hypertensive drugs which includes:

• Renin-Angiotensin system antagonists which has two classes of Angiotensin converting enzyme inhibitors block the conversion of Angiotensin 1 to Angiotensin 2 and Angiotensin receptor blockers block the action of Angiotensin 2 at the angiotensin 2 type 2i receptor. ACE inhibitors includes Ramipril, Lisinopril, Enalapril, and Perindopril. ARB's includes Losartan, Telmisartan, Irbesartan, and Valsartan.

• Calcium Channel Blockers blocks slow calcium channels in the peripheral blood vessels of the heart. Dihydropyridines include Amlodipine, Felodipine, Lacidipine. Non-dihydropyridines include Diltiazem and verapamil.

• Diuretics reduces blood pressure by reducing the circulating blood volume, but in long term they reduce total peripheral resistance. Hydrochlorothiazide, Bendroflumethiazide are thiazide type diuretics. Furosemide and Bumetanide are loop diuretics.

• Beta Blockers reduces cardiac output in short term and during Exercise. Bisoprolol, metoprolol, Labetalol, Propranolol, Atenolol are commonly used beta adrenoreceptor blockers.

• Other agents includes alpha blockers such as doxazosin, Prazosin and centrally acting vasodilator includes Methyldopa and moxonidine.

LIFESTYLE MODIFICATIONS:

Non pharmacological management of hypertension is an important aspect of treatment for all people with hypertension and considered as the first line strategy to lower of cardiovascular events. Lifestyle advises should include weight loss, diet and physical activity, decreased salt and alcohol intake, smoking cessation. The Dietary Approaches to Stop Hypertension (DASH) diet was evaluated in a clinical trial and found to lower blood pressure significantly. The diet includes fruit, vegetables, low fat diary products, fish, low fat poultry and whole grains whereas minimizing red meat, confectionaries and sweetened drinks. 

In patients who are overweight, reductions in systolic blood pressure of 0.5-2 mmHg per Kg weight loss can be achieved.