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UPDATE ON MANAGEMENT OF HYPERTENSION. Classification of BLOOD PRESSURE for adults 18 yrs. Or older. T.O.D .( Target Organ Damage ). Target Organs. Brain Eye Heart Blood vessels Kidney. BRAIN Stroke : H’gic / ischaemic Hypertensive Encephalopathy EYE Hypertensive retinopathy
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Classification of BLOOD PRESSURE for adults 18 yrs. Or older
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.