Goals of Drug Therapy for Hypertension and Antihypertensive Treatments

Goals:

The primary goal of drug therapy for hypertension is to reduce blood pressure (BP) to a target level to prevent complications like heart attack, stroke, heart failure, and kidney disease.

Target Blood Pressure Levels:

• Normal: Less than 120/80 mmHg
• Elevated: Systolic 120-129 and diastolic less than 80 mmHg
• Stage 1 Hypertension: Systolic 130-139 or diastolic 80-89 mmHg
• Stage 2 Hypertension: Systolic greater than 140 or diastolic greater than 90 mmHg

Antihypertensive Treatments:

• Diuretics: Increase urine output to reduce blood volume. (e.g., hydrochlorothiazide, chlorthalidone)
• ACE Inhibitors: Relax blood vessels by blocking angiotensin-converting enzyme. (e.g., lisinopril, enalapril)
• Angiotensin II Receptor Blockers (ARBs): Block the action of angiotensin II, a hormone that constricts blood vessels. (e.g., losartan, valsartan)
• Calcium Channel Blockers: Relax blood vessels by preventing calcium from entering smooth muscle cells. (e.g., amlodipine, nifedipine)
• Beta-Blockers: Slow heart rate and decrease force of heart contractions. (e.g., metoprolol, atenolol)
• Renin Inhibitors: Reduce production of renin, an enzyme involved in blood pressure regulation. (e.g., aliskiren)
• Vasodilators: Directly relax blood vessels. (e.g., hydralazine)

Treatment is chosen based on individual factors like:

• Severity of hypertension
• Age
• Underlying medical conditions
• Side effects

Types of Arrhythmias and Treatment

An arrhythmia is an abnormal heart rhythm. The heart has a natural electrical impulse that coordinates contractions. When this rhythm is disrupted, arrhythmias occur.

Types of Arrhythmias:

• Bradycardia: Slow heart rate (less than 60 beats per minute)
  • Treatment: Pacemaker implantation, medications (atropine)
• Tachycardia: Fast heart rate (more than 100 beats per minute)
  • Subtypes: Atrial fibrillation, ventricular fibrillation, atrial flutter, etc.
  • Treatment: Medications (beta-blockers, calcium channel blockers), electrical cardioversion, ablation (destroying a small area of heart tissue causing the arrhythmia)
• Premature beats: Extra heartbeats that originate from the atria (atrial premature contractions) or ventricles (ventricular premature contractions)
  • Treatment: Medications (beta-blockers), lifestyle changes (stress management)
• Heart block: Electrical impulse is blocked from reaching the ventricles
  • Treatment: Pacemaker implantation

Atrial Fibrillation (AFib)

Description: Most common sustained arrhythmia. The upper chambers of the heart (atria) beat irregularly instead of contracting in a coordinated way. This disrupts blood flow and increases the risk of blood clots.

Symptoms: Palpitations, shortness of breath, fatigue, chest pain, lightheadedness

Treatment:

• Rate control medications: Slow down the heart rate (beta-blockers, calcium channel blockers)
• Rhythm control medications: Attempt to restore a normal heart rhythm (antiarrhythmics)
• Anticoagulant medications (blood thinners): Reduce the risk of blood clots (warfarin, apixaban, rivaroxaban)
• Catheter ablation: Destroys a small area of heart tissue causing AFib

Types of Anemia, Causes, Symptoms, and Treatments

Anemia is a condition characterized by a deficiency in red blood cells or hemoglobin, the protein in red blood cells that carries oxygen. This leads to a reduced ability of the blood to carry oxygen to tissues.

Types of Anemia:

• Iron Deficiency Anemia: Most common type, caused by lack of iron.
  • Causes: Blood loss, poor diet
  • Symptoms: Fatigue, pale skin, shortness of breath, weakness
  • Treatment: Iron supplements, address underlying cause of blood loss
• Vitamin B12 Deficiency Anemia: Caused by lack of vitamin B12.
  • Causes: Poor diet, autoimmune disease (pernicious anemia)
  • Symptoms: Fatigue, weakness, tingling or numbness in hands and feet, cognitive decline
  • Treatment: Vitamin B12 injections or supplements
• Folate Deficiency Anemia: Caused by lack of folate (vitamin B9).
  • Causes: Poor diet, pregnancy
  • Symptoms: Similar to B12