Download Hypertension

Hypertension:
What is hypertension? This is the medical term used to describe high blood
pressure either systolic ( the number on the top) or diastolic (the number on the
bottom). Your blood pressure is the force the blood exerts against the artery walls
as it travels through your body. According the the JNC -7, a normal blood pressure
is a systolic pressure less than 120 and a diastolic pressure less than 80.
Prehypertension is classified as a systolic pressure between 120-139 and diastolic
between 80-89. Stage 1 of hypertension is defined as a systolic pressure from
140-159 and diastolic from 90-99. Stage 2 hypertension is defined as systolic
pressure from 160 or higher and diastolic higher than 100.
What are the main causes of hypertension?
-Being overweight
-Smoking
-High salt intake
-Excessive alchohol use
-Lack of exercise
-Not eating enough broccoli and eating too many potato chips
-Aging and stiffening of the artery walls
Reversible causes of hypertension
There are some individuals that may be diagnosed with a reversible cause for
their high blood pressure. Blockages in the arteries that supply blood to the
kidneys can make the blood pressure elevated. This condition is called renal
artery stenosis. If you have this condition, usually a stent can be placed in that
artery that can help lower the blood pressure. Sleep apnea can also contribute to
high blood pressure (as well has abnormal heart rhythms, heart failure, heart
attacks, stroke) and is usually diagnosed with a sleep study. Sometimes losing
weight may be enough to treat this condition, but in many cases a device is
prescribed to sleep with. Some other reversible causes are pheochromocytoma,
cushing’s syndrome, thyroid or parathyroid disease, kidney disease,
hyperaldosteronism, and an abnormality of the aorta called coarctication.
Why is it important to treat high blood pressure?
This fact says it all. By lowering the systolic blood pressure if it is elevated by just
5 points, that would result in a 14 percent decrease in stroke, a 9 percent
decrease in heart disease, and 7 percent decrease in death (1). If that wasn’t
enough, uncontrolled high blood pressure can lead to kidney failure and also your
blood vessels causing aneurysms.
What is the treatment?
There are several methods of treatment for hypertension. The most important is
to address the causes. What we call lifestyle modifications are usually the best
medication that can be prescribed. Losing weight, cutting back on alcohol intake,
exercising, and decreasing sodium in the diet are all ways to lower the blood
pressure. If you fall in the prehypertension range, this is usually recommended
first and then continue to follow it. For people that fall under stage 1 or 2, usually
medications in addition to the lifestyle modifications are prescribed. Commonly
used medications used are listed below:
(Please note, this list does not include every drug used to treat hypertension)
Diuretics:
Hydrochlorothiazide
Chlorthalidone
Metolazone
Indapamide
Bumetanide
Furosemide
Torsemide
Triamterene
Microzide
Zaroxlyn
Lozol
Bumex
Lasix
Demadex
Dyrenium
Generic *
Generic
Generic
Generic *
Generic *
Generic*
Generic*
Eplerenone
Spironolactone
Inspra
Aldactone
Generic*
Beta Blockers:
Atenolol
Carvedilol
Metoprolol tartrate
Metoprolol succinate
Bisoprolol
Nebivolol
Propranolol
Tenormin
Coreg
Lopressor
Toprol XL
Zebeta
Bystolic
Inderal
Generic*
Generic*
Generic*
Generic
Generic*
Generic
FYI: Many patients or the pharmacies may substitute metoprolol succinate for metoprolol tartrate because it is
cheaper. There is a difference, the succinate or XL form only has to be taken once a day and it is also approved for
heart failure. The tartrate form has to be taken twice a day and is not approved for heart failure. Please make sure
you are taking this the correct way and check with your healthcare provider before changing to a different form.
Ace-Inhibitors:
Lisinopril
Benazapril
Enalapril
Fosinopril
Moexipril
Quinapril
Ramipril
Trandolopril
Captopril
Zestril
Lotensin
Vasotec
Monopril
Univasc
Accupril
Vasotec
Mavik
Capoten
Generic*
Generic*
Generic*
Generic
Generic
Generic
Generic
Generic
Generic*
Atacand
Avapro
Cozaar
Benicar
Not Generic
Not Generic
Generic
Not Generic
ARB’s:
Candesartan
Irbesartan
Losartan
Olmesartan
Telmisartan
Valsartan
Azilsartan
Eprosartan
Micardis
Diovan
Edarbi
Tevetan
Not Generic
Not Generic
Not Generic
Not Generic
Calcium Channel Blockers:
Nondihydropyridines:
This class of calcium channel blockers is good for high blood pressure but do slow
down the heart rate and may not be indicated in every patient because of this.
They are also, in most cases, contraindicated in congestive heart failure.
Diltiazem short acting
Diltiazem long acting
Cardizem
Diltia, Cardizem LA, CD,
Tiazac, Dilacor XR
Generic*
Generic
Verapamil short acting
Verapamil long acting
Calan
Calan SR, Verelan PM
Generic*
Generic
Dihydropyridines:
This class of calcium channel blockers is commonly used. These drugs do not slow
the heart rate or worsen congestive heart failure.
Amlodopine
Felodipine
Isradipine
Nicardipine sustained
release
Nifedipine
Nisoldipine
Norvasc
Plendil
Dynacirc CR
Cardene SR
Generic
Adalat CC, Procardia XL
Sular
Generic
Generic
Generic
Generic
Alpha-1 Blockers:
Doxazosin
Prazosin
Terazosin
Cardura
Minipress
Hytrin
Generic*
Generic*
Central Alpha-2 Blockers and other central acting drugs:
Clonidine
Clonidine Patch
Methyldopa
Guanfacine
Catapres
Catapres-TTS
Aldomet
Tenex
Generic*
Apresoline
Loniten
Generic*
Generic
Generic*
Generic*
Direct Vasodilators:
Hydralazine
Minoxidil
Remember both medications and lifestyle modifications are extremely important
in controlling your blood pressure. Many people require more than one drug to
reach their blood pressure goals. This article is just an education tool for you and
does not serve as medical advice. Each individual and situation is unique and only
your health care provider knows the full details of your situation.
References
1. Whelton PK, et al. Primary prevention of hypertension: Clinical and public health advisory from
The National High Blood Pressure Education Program. JAMA 2002;288:1882–8.
2. JNC7.The Seventh Report of the Joint National Committee on Prevention, Detection, Evalutation,
andTreatment of high blood pressure.NIH Publication No.04-5230; August 2004.
3. Opie, L.H.(1997) The Pharmacological Differences in Calcium Antagonist, European Heart
Journal; 18 Supplement A: A71-92.
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