UPDATE ON MANAGEMENT OF HYPERTENSION. Classification of BLOOD PRESSURE for adults 18 yrs. Or older BP ClassificationSystolic BP, mm of hgDiastolic BP,

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Presentation transcript:

UPDATE ON MANAGEMENT OF HYPERTENSION

Classification of BLOOD PRESSURE for adults 18 yrs. Or older BP ClassificationSystolic BP, mm of hgDiastolic BP, mm of Hg Normal<120<80 Prehypertension Stage 1 Htn Stage 2 Htn.>160>100

T.O.D.( Target Organ Damage )

Target Organs Brain Eye Heart Blood vessels Kidney

BRAIN Stroke : H’gic / ischaemic Hypertensive Encephalopathy EYE Hypertensive retinopathy Heart Left Ventriculr Hypertrophy Diastolic Dysfunction Coronary Artery disease Chronic Heart failure Kidney Nephrosclerosis Chronic Kidney disease

What is Compelling indication? When hypertension is associated with a co -morbid condition, selection of a particular class of drug is recommended as drug of first choice.

Drugs for Hypertension A. ACEI / ARB B. Beta blockers C. Calcium Channel blockers D. Diuretics

Compelling Indications ACEI / ARB : HTN. With Diabetes B-Blocker : HTN. With CAD Calcium channel blocker : HTN with Stroke Diuretics : Chronic heart failure

KEY POINTS More than one drug is required to achieve goal BP in the vast majority of Hypertensives. Combining drugs that work by complimentary pharmacologic mechanism improve overall efficacy, speed of BP control, predictability, and tolerability Fixed-drug combinations simplify treatment regimens and promote adherence. Most fixed drug combinations include a diuretic or calcium channel blocker with an ACEI / ARB, or B blocker.