The New Drugs to Treat Hypertension Essay example

ACE inhibitors are important and useful in the medication and treatment for KH due to their effectiveness in treating hypertension. ACE inhibitors will help treat KH by slowing the angiotensin converting enzyme (ACE). Angiotensin II is produced by the body that can cause vasoconstriction of the blood vessels. Angiotensin II is made from Angiotensin I by the ACE. If the production of Angiotensin II is slowed by the ACE inhibitor, the blood vessels will be able to dilate, and blood pressure is able to be lowered (Copstead and Banasik). Thus, it is important for KH to stay on the ACE inhibitors due to his blood pressure readings. KH’s blood pressure is 135/96. His systolic blood pressure is in the pre-hypertensive range, however, his diastolic blood pressure is in the hypertensive range and therefore, his blood pressure is hypertensive. Since his blood pressure is high, it is important for KH to remain taking the

The concern regarding the use of anti-hypertensive medication as a treatment procedure for hypertension has mainly been centered on the optimal choice of these agents. The other factors include the side effects of these drugs on a hypertensive patient, especially coughing. While three categories of these drugs are linked with cough as a side effect, they have varying casual explanations though angiotensin-converting enzyme (ACE) inhibitors play a crucial role (Van Amburgh, 2011). The main objective for the use of anti-hypertensives in dialysis patients is to obtain and sustain an optimal blood pressure or lessen it by the least intrusive measures possible. While this is not

The major health problem selected for this project was hypertension (Harrison et al, 2011). It is identified as a cardio vascular disease risk factor such as dementia, chronic kidney disease, coronary heart disease, and stroke (NICE, 2011). It can be missed easily, as in various instances it is asymptomatic as well as it is also known as a silent killer. The Hypertension is thought to be a disease of vascular regulation ensuing from arterial pressure control mechanisms malfunction (extracellular fluid volume, rennin-angiotensin-aldosterone system, and CNS) that results in elevation of BP by means of enhanced peripheral vascular resistance, and cardiac output. There are 2 basic hypertension types. Around 90 to 95 percent of the individuals have primary hypertension which is linked with change in lifestyle as well as needs medical treatment. On the other hand, 5-10% has secondary hypertension which is linked with various other diseases for instance pregnancy, thyroid, and renal (Haslam and James, 2005). It is estimated that around 1 in 20 adults will have increased BP of 160/100 mmHg and above that results in either more than one predisposing aspects (Gemmell et al, 2006).

According to JNC 8 guidelines, close monitoring is essential when patients start on new hypertensive medication. Therefore, Mr. Hightower will require frequent visits to the clinic to ensure improvement in his health condition. His blood pressure will be monitored at each visit and blood work will be done to monitor his kidney and liver functions and to determine his adherence to treatment. In case of noncompliance, a third category of antihypertensive must be added to improve hypertension outcomes and prevent cardiovascular disease.

JNC 8 has a hypertension guideline algorithm. Patients older than 60 should be placed on pharmacological treatment if SPB is 150 mm Hg or higher and DBP is 90 mm Hg or higher. Target goal is 150/90 Patient less than 60 should be placed on pharmacological treatment if SPB is 140 mm Hg or higher and DBP is 90 mm Hg or higher. Target goal is 140/90. Initial drug of choice for nonblack patients is an ACEI, ARB, thiazide or CCB alone or in combination. Black patients should be started on a thiazide or CCB alone or in combo. It is recommended to start one drug titrate to maximum dose and then add another drug if target goal has not been achieved. Combination therapy is recommended if BP is greater than 20/10 mm Hg from target. I also gives a guideline for all ages if the patient is diabetic without kidney disease or the patient has kidney disease without diabetes (Armstrong, 2014).

Pharmacological treatments with diuretics, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers or aldosterone antagonist, and beta-blockers are essential for the treatment of heart failure and are effective in improving symptoms of heart failure and patient well-being. Diuretics are administered to help get rid of the excess fluid that helps improve breathing associated with shortness of breath, at rest or on exertion. Diuretics provide relief from symptoms and signs of pulmonary and venous congestion by promotion of fluid loss through the kidneys. Diuretics, for example, Furosemide helps improve breathing status, but monitoring patients for dehydration and kidney problems is crucial. Patient education is essential to ensuring medication adherence and early identification of adverse effects and potential for drug interactions.

The algorithm begins with an indication that is used for adults over the age of 18 and noted that lifestyle interventions should be continued throughout management. Goal blood pressures are separated by age and presence of chronic disease. The goal for patients over 60 is SBP < 150 mmHg and DBP < 90 mmHg. The goal for patients under 60 is < 140 mmHg and DBP < 90 mmHg. Different goal values are presented for patients with chronic conditions. Treatment with medication is categorized by: general population nonblack, general population black, chronic conditions black, and chronic condition all races. Based on the algorithm black patients should only be prescribed thiazide type diuretics and/or calcium channel blockers. While non-black patients can take all of the medications listed in JNC 8 (thiazide type diuretics, ACEI, ARB, and/or CCB). If patient does not reach goal blood pressure then three strategies are listed, along with lifestyle adherence. The algorithm also explains not to use ACEI and ARB together. The final option for patients not at goal blood pressure includes additional medications and/or referral to physician with an expertise in hypertension

The author also uses images to help understand the topic how CHF happens more efficiently. Further more in the article the author discusses how the nurses should manage CHF representing what medications are important elements of CHF treatment, such as angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptors blockers (ARBs), which the are key medication in managing CHF. Further more William & Wilkins (2012) indicate that diuretics are another class of medication that plays a major role in the treatment of CHF. The article also discusses other options that are available for patient whose condition is not under control, such as medical devices: pacemakers and other devices that can be implanted. For patient that in there last stage of CHF, the author suggested that palliative care and or hospice

There are a plethora of treatments available for patients with heart failure including but not limited to diuretics, ACE inhibitors, angiotensin receptor blockers, and oral nitrates. The Vasodilator heart failure (V-HEFT) studies show that enalapril has less cumulative mortality among study participants when compared to patients taking a combination of isosorbide dinitrate and hydralazine. (MGMT) This is not to say that the combination of isosorbide dinitrate and hydralazine is not efficacious because when compared to placebo, mortality rates improved with the combination treatment.

Since this enzyme is being blocked, the blood vessels are able to widen and relax, causing the blood to flow through the vessels much easier. This relaxation and widening of the vessel will cause the blood pressure to decrease because the heart does not have to work as hard. The medication should be taken once each morning, with or without food. Take the pill with a full glass of water. Make sure you are checking your blood pressure each morning before taking your pill. If your blood pressure is lower than what the doctor has set your guidelines than withhold the drug and contact your physician. Make sure to take exact amount of medication prescribed by your

About seventy million American Adults have hypertension or high blood pressure. Hypertension increases the risks for a cerebral vascular accident, heart failure/disease/attack, and kidney disease, which are leading causes of death (Mann, 2012). The treatment for hypertension includes lifestyle changes and Drug therapy. There are four drug categories involved in the treatment of hypertension two of which are Calcium channel blockers and Sympatholytics (Mann, 2012). This paper will assess the various aspects of the different calcium channel blockers and the specific contraindication with beta-blockers, which pertain to the sympatholytic class. As mentioned above, calcium channel blockers or CCB’s

When treating hypertension with Verapamil the normal dosage is 80mg three times a day which would give you a total of 240mg a day but of

The major action of thiazide is to inhibit sodium chloride transport in the early segment of the distal convoluted tubule. Thiazide are orally administrated and activated, their duration of action is of 6 to 12 hours (Katzung & Trevor, 2015).

BiDil is a combination of isosorbide dinitrate (vasodilator) and hydralazine (antihypertensive). It showed promise for efficacy

Consequently, the use of diuretics as antihypertensive agents has been relatively reduced, particularly since the newer drugs are associated with fewer adverse metabolic reactions. However, diuretics have a specific activity of removing sodium from the body fluid, thereby rendering the blood pressure insensitive to sodium intake, relieving the overload to systemic circulation, and normalizing the circadian rhythm of blood pressure from a non-dipper to a dipper pattern. At low doses, diuretics are known to be as effective as all other antihypertensive agents for reducing nearly all types of cardiovascular events. In this brief review, the indication for thiazide diuretics will be discussed based on the pathophysiology of hypertension and antihypertensive therapy with diuretics mainly from the point of view of sodium