refers to high Blood pressure.
Hypertension is amongst the major health disorder as it does not have any symptoms and in most cases it is not detected. Hypertension is a serious condition as it increases the risk of heart disease and other medical problems. If left untreated it may lead to arteriosclerosis/atherosclerosis, Myocardial Infarction, stroke, Kidney damage.
Primary Hypertension also known as Essential hypertension/ Idiopathic hypertension is most common and complex type of hypertension and is found in more than 90 % of the hypertensive population. By definition it has no direct causes but is a result of sedentary lifestyle and obesity.
Secondary Hypertension by definition is a result of identifiable causes. It is very important to detect Secondary Hypertension as the treatment for Secondary hypertension is associated with treating the cause. Secondary Hypertension results from the interplay of several pathophysiological mechanisms regulating plasma volume, peripheral vascular resistance and cardiac output, all of which may be increased.
- Malignant hypertension
- Paroxysmal hypertension
- Portal hypertension
- Pulmonary hypertension
- Renovascular hypertension
- Rebound Hypertension
In order to reduce the risk of risk of stroke, heart attack, and kidney failure the detection and at an early stage is necessary.
Depending on the severity and seriousness of the disease, the treatment for hypertension in the initial stages is associated with lifestyle improvement and diet improvement. If the lifestyle changes are ineffective or the presenting blood pressure is critical, then drug therapy is initiated, often requiring more than one agent to effectively lower hypertension.
Following class of medications are used for the treatment of Hypertension
Inhibitors act by inhibiting the Angiotensin Converting Enzyme. Angiotensin Converting Enzyme converts the inactive form of Angitensin I (inactive) to its active form Angiotensin II, this active form of Angiotensin causes Vasoconstriction. Thus by inhibiting the Angitensin Converting Enzyme, ACE Inhibitors result in Vasodilation and thereby reducing the blood pressure. This leads to decreased work-load of the heart. ACE inhibitors also reduce blood pressure in the kidneys, slowing the progression of kidney disease due to high blood pressure or diabetes.
Angiotensin II is the active form of angiotensin I which by interaction with its receptors causes vasoconstriction. Angiotensin II receptor Antagonism leads to vasodilation and hence lowering of blood pressure and decreased work-load of the heart.
Calcium is required by the heart and arteries muscle cells for causing Contraction. Calcium Channel Blockers inhibit the movement of Calcium in the muscle cells of the heart and the arteries.Thus Calcium Channel Blockers act by lowering blood pressure by decreasing the force of the heart's pumping action (cardiac contraction) and relaxing the muscle cells in the walls of the arteries.
Alpha-blockers lower blood pressure by blocking alpha-receptors in the smooth muscle of peripheral arteries throughout the tissues of the body. The alpha-receptors are part of the sympathetic nervous system and serve to cause peripheral Vasoconstriction and blocking these receptors lead to vasodilation and lower blood pressure.
Eg. tamsulosin or alfuzosin are alpha-blockers that work well in combination with other anti-hypertensive medications.
Diuretics specially thiazide Diuretics are used as the first line treatment for Hypertension. These prevent the binding and transport of chloride ions into the distal tubular epithelial cell, thereby inhibiting the cotransport of sodium. Thiazides are the most commonly used diuretics for treating hypertension, in part because their diuretic effect is accompanied by a reduction in peripheral resistance after prolonged administration that further reduces blood pressure.