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Hypertension is the term used to describe high blood pressure.Blood pressure is a measurement of the force against the walls of your arteries as your heart pumps blood through your body. Blood pressure readings are usually given as two numbers -- for example, 120 over 80 (written as 120/80 mmHg). One or both of these numbers can be too high. The top number is called the systolic blood pressure, and the bottom number is called the diastolic blood pressure.. Normal blood pressure is when your blood pressure is lower than 120/80 mmHg most of the time. High blood pressure (hypertension) is when your blood pressure is 140/90 mmHg or above most of the time.
If your blood pressure numbers are 120/80 or higher, but below 140/90, it is called pre-hypertension
Causes:
Many factors can affect blood pressure, including: How much water and salt you have in your body The condition of your kidneys, nervous system, or blood vessels The levels of different body hormones You are more likely to be told your blood pressure is too high as you get older. This is because your blood vessels become stiffer as you age. When that happens, your blood pressure goes up. High blood pressure increases your chance of having a stroke, heart attack, heart failure, kidney disease, and early death. You have a higher risk of high blood pressure if you: Are African American Are obese Are often stressed or anxious Drink too much alcohol (more than one drink per day for women and more than two drinks per day for men) Eat too much salt in your diet Have a family history of high blood pressure Have diabetes Smoke Most of the time, no cause of high blood pressure is found. This is called essential hypertension. High blood pressure that is caused by another medical condition or medication is called secondary hypertension. Secondary hypertension may be due to: Chronic kidney disease Disorders of the adrenal gland (pheochromocytoma or Cushing syndrome) Pregnancy (see: preeclampsia) Medications such as birth control pills , diet pills, some cold medications , and migraine medications Narrowed artery that supplies blood to the kidney (renal artery stenosis) Hyperparathyroidism
Symptoms
Most of the time, there are no symptoms. For most patients, high blood pressure is found when they visit their health care provider or have it checked elsewhere. Because there are no symptoms, people can develop heart disease and kidney problems without knowing they have high blood pressure. If you have a severe headache nausea or vomiting bad headache confusion changes in your vision or nosebleeds you may have a severe and dangerous form of high blood pressure called malignant hypertension.
Treatment
The goal of treatment is to reduce blood pressure so that you have a lower risk of complications. You and your health care provider should set a blood pressure goal for you. If you have pre-hypertension, your health care provider will recommend lifestyle changes to bring your blood pressure down to a normal range. Medicines are rarely used for pre-hypertension. Often, a single blood pressure drug may not be enough to control your blood pressure, and you may need to take two or more drugs. It is very important that you take the medications prescribed to you. If you have side effects, your health care provider can substitute a different medication.
Beta blockers work by changing how certain sensors in the body, called beta receptors, respond to signals from the central nervous system. These medications are used to treat heart and blood pressure problems because both the heart and blood vessels have very high numbers of beta receptors. There are
also high numbers of beta receptors in the lungs, but these receptors are slightly different in structure. Cardioselective beta blockers are able to tell the two apart. The cardioselective beta blockers
atenolol
atenolol 50-100mg
ateno50-100mg
atenolol50-100mg
blockium50-100mg
tenormin25-50-100mg
tensolol50-100mg
bisoprolol
bisocard5-10mg
concor2.5-5-10mg
bistol10mg
nebivolol
niblet5mg
symbian 5mg
sotolol
betacor
cardilol 25
dilatrol
carvid 6.25-25mg
carvipress
carvena
carvedolol
myodura
norvasc
vasonorm
regcor
cardiovasc
deltiazem 60-90-120-180mg
telzim sr
nimotop
tildiem
slow-zem
peltiam
mono tidiem
dilatcor-xl
delay-tiazem sr
altiazem
felodipine 2.5-5-10mg
logimax
plentopine
plendil
felocor
nitrate
mechanism of action : General Pharmacology
Nitric oxide (NO), a molecule produced by many cells in the body, and has several important actions (click here for details). In the cardiovascular system, NO is primarily produced by vascular endothelial cells. This endothelial-derived NO has several important functions including relaxing vascular smooth muscle (vasodilation), inhibiting platelet aggregation (anti-thrombotic), and inhibiting leukocyte-endothelial interactions (anti-inflammatory). These actions involve NOstimulated formation of cGMP. Nitrodilators are drugs that mimic the actions of endogenous NO by releasing NO or forming NO within tissues. These drugs act directly on the vascular smooth muscle to cause relaxation and therefore serve as endothelial-independent vasodilators.
There are two basic types of nitrodilators: those that release NO spontaneously (e.g., sodium nitroprusside) and organic nitrates that require an enzymatic process to form NO. Organic nitrates do not directly release NO, however, their nitrate groups interact with enzymes and intracellular sulfhydryl groups that reduce the nitrate groups to NO or to Snitrosothiol, which then is reduced to NO. Nitric oxide activates smooth muscle soluble guanylyl cyclase (GC) to form cGMP. Increased intracellular cGMP inhibits calcium entry into the cell, thereby decreasing intracellular calcium concentrations and causing smooth muscle relaxation (click here for details). NO also activates K+ channels, which leads to hyperpolarization and relaxation. Finally, NO acting through cGMP can stimulate a cGMP-dependent protein kinase that activates myosin light chain phosphatase, the enzyme that dephosphorylates myosin light chains, which leads to relaxation. Tolerance to nitrodilators occurs with frequent dosing, which decreases their efficacy. The problem is partially circumvented by using the smallest effective dose of the compound coupled with infrequent or irregular dosing. The mechanism for tolerance is not fully understood, but it may involve depletion of tissue sulfhydryl groups, or scavenging of NO by superoxide anion and the subsequent production of peroxynitrite that may inhibit guanylyl cyclase.
Cardiac
reduced preload and afterload (decreased wall stress) decreased oxygen demand
Coronary
prevents/reverses vasospasm vasodilation (primarily epicardial vessels) improves subendocardial perfusion increased oxygen delivery Although nitrodilators can dilate both arteries and veins, venous dilation predominates when these drugs are given at normal therapeutic doses. Venous dilation reduces venous pressure and decreases ventricular preload. This reduces ventricular wall stress and oxygen demand by the heart, thereby enhancing the oxygen supply/demand ratio. A reduction in preload (reduced diastolic wall stress) also helps to improve subendocardial blood flow, which is often compromised in coronary artery disease. Mild coronary dilation or reversal of coronary vasospasm will further enhance the oxygen supply/demand ratio and diminish the anginal pain. Coronary dilation occurs primarily in the large epicardial vessels, which diminishes the likelihood of coronary vascular steal. Systemic arterial dilation reduces afterload, which can enhance cardiac output while at the same time reducing ventricular wall stress and oxygen demand. At high concentrations, excessive systemic vasodilation may lead to hypotension and a baroreceptor reflex that produces tachycardia. When this occurs, the beneficial effects on the oxygen supply/demand ratio are partially offset. Furthermore, tachycardia, by reducing the duration of diastole, decreases the time available for coronary perfusion, most of which occurs during diastole (click here for more details).
effox
ismo
imdur
cardiket
coronit
dinitra
isomack
isordil
nitroglycerin
angised
nitromack retard
nitroderm tts
nitroguard
nitronal
nitrostat
nitrotard
deponitnt5
nitrocare SR
tridil
Angiotensin II Receptorantagonist
valsartan
disartan
tareg
valsar
idisartan
losartan potasium
losartan
remtozar
lozapress
lozar
kanzar
cozaar
amozar
losarmepha
irbesartan
aprovel
eprosartan
teveten
telmisartan
micardis
candisartan
atacand
atacand plus
candesar
inhibitors and also some of the side effects of ACE inhibitors (cough and angioedema). ARBs have the following actions, which are very similar to ACE inhibitors: Dilate arteries and veins and thereby reduce arterial pressure and preload and afterload on the heart. Down regulate sympathetic adrenergic activity by blocking the effects of angiotensin II on sympathetic nerve release and reuptake of norepinephrine. Promote renal excretion of sodium and water (natriuretic and diuretic effects) by blocking the effects of angiotensin II in the kidney and by blocking angiotensin II stimulation of aldosterone secretion. Inhibit cardiac and vascular remodeling associated with chronic hypertension, heart failure, and myocardial infarction.
lisinopril
lisopril
lisinopril
sinopril
zestril
maxitrel
perindopril
coversyl
adwipril
enalpril
acapril
enalapril
lotrial
ezalapril
renitic
press light
benzapril
cibacen
ramipril
ramitac
tritace
tritace protect
ramipril
corpril
moexipril
primox
captopril
capoten
captopril
lotensine
hypopress
fosinopril
monopril
catapress
phentolamine
rogitine
prazocin
minipress
methyl dopa
methyldopa
aldomet
adamat
kadomet
farcodopa
epidopa
vasodilator antihypertensive
sodium nitroprusside
niprid
nipruss
sodium nitroprusside
dobutrix
dobutamine
adrenaline
adrenaline
dopamine
dopamine
intropin
isoprenaline
isupril
natural product
hybisc master-hibiscus royatens
multiingredient
atenolol+chlorthalidone 50-100+12.5-25mg tenoret tenoretic
blockium diu
tenedone
capotril+indapamide 33+3mg
normaten
verpamil+trandolapril 180+2mg
tarka
teklo
hipress D
atenoretic
atenolol+nefidipine
tenolat SR
amlodipine +valsartan
exforge 5_10+160mg
resperine+clopramide+dihydroergocristine 1+5+0.1mg
brinerdin
hypoten
bisoprolol+hydrochlorthalidone 2.5-5-10+6.25-12.5-25mg
lodoz
concor plus 5
concor plus 10
bisocard plus
bistol plus
cardivo care
captopril+hydrochlorthalidone 50+25mg
capozide
farcopril plus
capojed H
hypopress D
ramipril+hydrochlorthalidone 2.5-5+12.5-25mg
tritace comp
tritace comp l s
fosinopril+hydrochlorthalidone 10-20+12.5mg
monozide
valsartan+hydrochlorthalidone 80-160+12.5mg
disartan co
co tareg
co diovan
benzapril+hydrochlorthalidone
cibradex 10-12.5mg
enalapril maleate+hydrochlorthalidone
co renitic 20+12.5mg
enalazide 10+1.5mg
thiazopril 20+12.5mg
ezapril co 20+12.5mg
lisinopril+hydrochlorthalidone
zestoretec 20+12.5mg
sinopril co 20+12.5mg
lisitens20+12.5mg
losartan k+hydrochlorthalidone
losartan comp50+12.5mg
losazide50+12.5mg
remtozar d 100+12.5mg
kanazar h 100+12.5mg
modazar 100+25mg
losarmephaplus50+12.5mg
fortzaar 100+25mg
hyzaar 50+12.5mg
hysartan 50+12.5mg
lora-z 50+12.5mg
irbesartan +hydrochlorthalidone
coaprovel 300mg+12.5mg
xtension 150+12.5mg
felodipine+metoprolol
logimax 5+50mg
minoxidil 2.5+5+10mg
loniten
minoxidil
There are three classes of imidazoline receptors:[1] I1 receptor mediates the sympatho-inhibitory actions of imidazolines to lower blood pressure, (NISCH or IRAS, imidazoline receptor antisera selected) I2 receptor an allosteric binding site of monoamine oxidase and is involved in pain modulation and neuroprotection. I3 receptor regulates insulin secretion from pancreatic beta cells Activated I1-imidazoline receptors trigger the hydrolysis of phosphatidylcholine into DAG. Elevated DAG levels in turn trigger the synthesis of second messengers arachidonic acid and downstream eicosanoids.[2] In addition, the sodium-hydrogen antiporter is inhibited, and enzymes of catecholamine synthesis is induced. The I1-imidazoline receptor may belong to the neurocytokine receptor family, since its signaling pathways are similar to those of interleukins.[2]
moxonidine
cynt 0.2-0.3mg
relminidine
hyperium0.4-1mg
If you smoke, quit -- find a program that will help you stop. Limit how much alcohol you drink -- one drink a day for women, two a day for men. Limit the amount of sodium (salt) you eat -- aim for less than 1,500 mg per day. Reduce stress -- try to avoid things that cause you stress. You can also try meditation or yoga. Stay at a healthy body weight -- find a weight-loss program to help you, if you need it
Possible Complications
When blood pressure is not well controlled, you are at risk for: Bleeding from the aorta, the large blood vessel that supplies blood to the abdomen, pelvis, and legs Chronic kidney disease Heart attack and heart failure Poor blood supply to the legs Stroke Problems with your vision
References:
http://www.nlm.nih.gov/medlineplus/ency/article/000468.htm http://www.medicinenet.com/high_blood_pressure/article.htm http://www.cvpharmacology.com/cardioinhibitory/beta-blockers.htm