2. :
❖Hypertension
➢ Hypertension is defined as either a
sustained systolic blood pressure (SBP)of
greater than 140 mm Hg or a sustained
diastolic blood pressure of greater than 90
mm of Hg.
➢An agent that reduces high blood
pressure is called as an
ANTIHYPERTENSIVE. 2
3. ➢Prehypertension-systolic between 120 to
139 mm/Hg and diastolic between 80 to 89
mm/Hg.
➢ Effects of Hypertension
✓Increases risk of heart disease ,
heartfailure, kidney disease, blindness,
and stroke.
✓ Primary Hypertension- No known
reason.
✓Secondary Hypertension-due to some
cause such as kidney disease,
abnormalities of adrenal glands
will try nonpharmacological methods first. 3
10. ❖Potassium Sparing
Diuretics:
Includes:
Spironolactone (a synthetic steroid that
antagonizes aldosterone at intracellular
cytoplasmic receptor site)
Triamterene & Amiloride (blocks Na
transport channels resulting in a decrease in Na/K
exchange)
10
11. ❖Loop Diuretics:
Inhibit the co-transport of Na/K/Cl in the
luminal membrane in the ascending limb of the
loop of Henle
Examples:Furosemide,Bumetanide,Ethacrynic
acid
11
16. ❖ACE
Inhibitors:
ACE Inhibitors blocks the ACE that
cleaves angiotensin-I to form the
16
potent vasoconstrictor angiotensin-II
by reducing circulating angiotensin-II
levels , ACE inhibitors also decrease
secretion of aldosterone, resulting in
decreased sodium & water retention.
18. Angiotensin II receptor
antagonist
They produce vasodilation and block
aldosterone secretion, thus lowering
blood pressure and decreasing salt
and water retention.
18
20. Calcium channel blockers:
It inhibits cellular influx of Ca, which is
responsible for muscle contraction.
Calcium channel blockers protect
tissue by inhibiting entrance of Ca
into cardiac & smooth muscle cells of
coronary & systemic arterial beds.
All Ca channel blockers are
vasodilators that ultimately cause
dilation of coronary & peripheral
arteries,reduce heart rate.
20
21. ➢α-1 adrenergic
receptors antagonist:
✓Decrease the peripheral vascular resistance
& lower the arterial blood pressure by
causing relaxation of both arterial & venous
smooth muscle
✓Examples:
Prazosin
Doxazosin
Terazosin
21
30. ET-1 is a more potent vasoconstrictor than
angiotensin II and has high affinity for the ETA
receptor subtype which mediates the
vasoconstriction characteristics of the Endothelin.
30
34. ❑CHYMASE INHIBITORS
Chymase inhibitors may be useful for
preventing cardiovascular diseases
and fibrosis via inhibition of
angiotensin II formation and
transforming growth factor-beta
activation.
E.g.,SPF-32629A
34
36. ❑CONTRAINDICATIONS
Antihypertensive drugs are contraindicated
in patients with known hypersensitivity to
the individual drug
ACEIs: Contraindicated in patients with
impaired renal function, congestive heart
failure, salt or volume depletion, bilateral
stenosis, or angioedema, also during
pregnancy or lactation
Use of the ACEIs and the angiotensin II
receptor blockers during the second and
third trimester of pregnancy is
contraindicated because use may cause
fetal and neonatal injury or death
36