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what do anti-hypertensive medications (AHMs) do?
lower blood pressure and control blood pressure
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what classifies hypertension?
blood pressure that is consistently (more than 6 months) above 140/90
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In 120/80...which number is systolic and which is diastolic?
120 (top number) is systolic and 80 (bottom number) is diastolic
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What are the causes of hypertension?
Can have no known cause or can be assosiated with other primary diseases (secondary hypertension)
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How do AHMs decrease blood pressure?
decrease blood volume, opens blood vessels, decreases rate and/or force of contractions of the heart
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How do AHMs open up blood vessels?
inhibiting constriction or stimulating dilation which makes it easier for blood to flow through the arteries
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What effect does decreasing the rate and/or force of heart contraction have on the arteries?
decreases the amount of blood pumped through the arteries
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what is the goal blood pressure of patients with diabetes or kidney disease?
< 130/80
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what is the optimal blood pressure for patient with no health conditions?
120/80
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Which is harder to control for most patients: systolic or diastolic?
systolic
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What are all of the classes of AHMs?
ACE inhibitors, beta-blockers, diuretics, calcium channel blockers, alpha blockers, alpha-beta blockers, angiotensin receptor blockers
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what does "ACE" stand for?
angiotensin converting enzyme
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What is the mechanism of action for AcE inhibitors?
Blocks the ACE, which prevents the conversion of Angiotensin I to Angiotensin II
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What effect does blocking Angiotensin II have?
relaxes and expands vessels thus reducing blood pressure
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Where do ACE inhibitors work?
kidneys
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What do ACE Inhibitors do?
lower blood pressure, treat heart failure, protect kidneys from damage (in patients with diabetes and hypertension), prevents early death in patients with hypertension
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What are the side effects of ACE inhibitors?
build up of bradykinin which causes dry hacking cough, elevation of potassium levels, dizziness, low blood pressure, headache, angioedema
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what is angioedema?
non-pitting edema that occurs as large erythematous areas in skin and sc tissues
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Why are some experts recommending these medications for middle-aged diabetic patients with type-II diabetes?
they may slow the progress of diabetic kidney disease
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ACE inhibitors are all very similar, but how do they differ from each other?
how they are eliminated from the body, their doses, some need to be converted into an active form in the body before they work, some may work more on ACE that is found in tissues than on ACE that is present in the blood
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What patients are not advised to take ACE inhibitors and why?
Pregnant women (can cause birth defects), patients with severe renal disease (will not be able to be eliminated properly), patients on NSAIDS (may dimish the antihypertensive effects)
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What is the brand name(s) for: Lisinopril
Zestril, Prinivil
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What is the brand name(s) for: Quinapril
Accupril
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What is the brand name(s) for:Enalapril
Vasotec
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What is the brand name(s) for:Benazepril
Lotensin
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What is the brand name(s) for:Fosinopril
Monopril
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What is the brand name(s) for:ramipril
Altace
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What is the brand name(s) for:captopril
Capoten
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