Management of hypertension

Presented by…….

TANMAY SAHA , TANAYA PALIT & TANUMOY GHOSHB.PHARM, 3RD YEAR, 6TH SEMESTER

ROLL No.- 18601913099 18601913097 18601913100

GURU NANAK INSTITUTE OF PHARMACEUTICAL SCIENCE & TECHNOLOGY

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Introduction:It is a cardio-vascular disease commonly

known as Arterial Hypertension ( AHT ) in which the blood pressure in arteries are elevated as more than 120/80 mm-Hg systolic & diastolic respectively.

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Classification of Hypertension:According to European Society of Cardiology,---

Hypertension is classified into 3 categories. These are following-----

Grade-I = Blood pressure is greater than 140/90 mm-Hg.

Grade-II = Blood pressure is greater than 160/100 mm-Hg.

Grade-III = Blood pressure is greater than 180/110 mm-Hg.

In India, 95% of the hypertensive patient having Grade-III Hypertension.

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Cause of Hypertension:

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Risk Factors of Hypertension:1. Hyperlipidemia ( Diposition of fat in arteries & kidney )2. Smoking3. Diabetes mellitus4. Stress ( Continuous production of O2

- )

HDL LDL

Blood pressure due to viscosity of blood . Blood pressure due to g.f.r to plasma volume.

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Smoking:

Tobacco

Nicotine N - receptorNN NM

Activation of these two receptor Adrenaline secretion Skeletal muscle contraction Activate β-receptor work capability Specially β1-receptor ( cardiac muscle) Rate & force of cardiac contraction Blood flow B.P

Management of Hypertension:TARGETS MECHANISM OF

ACTIONCLASSIFICATION OF ANTIHYPERTENSIVE DRUGS

PLASMA VOLUME(PV)

PV = Blood Volume = B.P ActivateV1 receptor of Vasopressin

Vasodialation

1. Diuretics: (Increase Urination) Thiazides: Hydrochlorothiazide High ceiling: Furosemide K+ Sparing: Spironolactone, Amiloride

2. Calcium channel blocker: Diltiazem, Verapamil, Nifedipine, Amlodipine

Cardiac Output (CO)

HR = CO = BP Activate β1 receptor

Rate & force of cardiac contraction

3. a) Non-selective β blocker: Propranolol b) Cardio selective β1 blocker: Metoprolol, Atenolol, Esmolol, Sotalol4. Vasodilators: Nitroprusside, Hydralazine

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TARGETS MECHANISM OF ACTION

CLASSIFICATION OF ANTIHYPERTENSIVE DRUGS

Peripheral Resistance (PR)(Ability of blood to flow into artery)

PR ∞ 1/diameter of arteriesBP = CO × PR BP = CO × PR BP = CO × PR BP = CO × PRIncreased PR is due to imbalance between vasoconstrictor & vasodialator molecule in favour of VC.

5. Direct Renin Inhibitor: Aliskiren, Remikiren, Fomikiren6. ACE Inhibitor: Captopril, Lisinopril, Rabepril7. AT1 Antagonist: Losartan, Condesartan, Valsartan, Telmesartan8. α1 Blocker: Prazosin, Terazosin, Doxazosin9. α+β Blocker: Labetelol, Carvedilol10. Central Sympatholytics: Methyl dopa, Clonidine

Normal condition

Hypertensive condition

VCVD

VCVD

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Conclusion: Hypertension is a very common disorder, particularly past

middle age. It is not a disease in itself, but is an important risk factor

for cardio-vascular mortality & morbidity. If hypertension not treated properly then it leads Angina

pectoris.

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Marketed antihypertensive drugs:

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References: KD Tripathi M.D., Essentials of Medical Pharmacology, 7th

Ed., Jaypee Brothers Medical Publishers (P) Ltd., Antihypertensive drug, Page no.: 558-574.

Anne Waugh, Allison Grant, Ross and Wilson Anatomy and Physiology in Health and Illness, 9th Ed., Churchill Livingstone, The cardiovascular System, Disorder of Blood Pressure, Hypertension, Page no.: 124-126.

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