 The heart is the vital organ in the body, which pumps the blood and the blood flows in the whole body through the vessels called the cardiovascular system (CVS). Hypertension i.e., high blood pressure, is a very common disorder, coccus due to excessive pressure, exerted against the wall of the arteries as it flows through them. It is also known as the “silent killer” because it usually occurs without any symptoms.

1. FACULTY OF PHARMACEUTICAL SCIENCE
PHARMACOTHERAPEUTICS ER20-24T
Chapter 2.1: Cardiovascular System
Topic 2.1.1. Hypertension
Presented by- Ms. ALKA
Assistant Professor
FACULTY OF PHARMACEUTICAL SCIENCE
RAMA UNIVERSITY UTTAR PRADESH
KANPUR, INDIA
2023-2024
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 The cardiovascular system consists of- the “heart” and the “blood vessels”.
 The heart is the vital organ in the body, which pumps the blood and the blood flows in the
whole body through the vessels called the cardiovascular system (CVS).
 Any obstruction or manifestation that occurs in the heart or blood vessels then leads to
many problems which are known to be cardiovascular disorders (CVD).
 Drugs having their major action on the heart or blood vessels, or those used primarily for
CVD are designated cardiovascular drugs.
 Anything that damages the heart, makes it less efficient, reduces its ability to pump blood,
or decreases the heart's supply of oxygen will disrupt the coordinated relationship between
the heart, kidney, and blood vessels and will harm not only the heart but the rest of the body
as well.
Cardiovascular system

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Hypertension i.e., high blood pressure, is a very common disorder, coccus due to
excessive pressure, exerted against the wall of the arteries as it flows through them. It
is also known as the “silent killer” because it usually occurs without any symptoms.
According to WHO guidelines the range to deciding hypertension is defined to be 140
mm Hg systolic and 90 mm Hg diastolic, while risk appears to increase even above
120/80 mm Hg.
Normal value
 Systolic pressure— 110 to 140 mmHg
 Diastolic pressure— 60 to 80 mmHg.
HYPERTENSION

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Classification of hypertension
Stages Systolic BP (mmHg) Diastolic BP (mmHg)
Normal Less than 120 Less than 80
Prehypertension 120-139 80-89
Stage 1 hypertension 140-159 90-99
Stage 2 hypertension 160 or higher 100 or higher
Stage 3 hypertension Higher than 180 Higher than 110
Types of Hypertension: Hypertension is mainly of two types.
1. Primary hypertension
2. Secondary hypertension

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 Primary (Essential) Hypertension: Primary Hypertension is the most common form of
high blood pressure. The exact cause of primary hypertension is often not clearly
understood, but it is thought to result from genetics, lifestyle, and environmental factors.
Risk factors for primary hypertension include age, family history, obesity, lack of physical
activity, high salt intake, excessive alcohol consumption, and stress.
 Secondary Hypertension: Secondary hypertension is caused by an underlying medical
condition or medication. Treating the underlying cause can often resolve or improve high
blood pressure. Some potential causes of secondary hypertension include Kidney
Problems, Hormonal Issues, Adrenal Gland Disorders, Obstructive Sleep Apnea etc.

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 Clinical manifestations
a) Headache, Fatigue
b) Dyspnea (Shortness of Breath)
c) Chest Pain, Dizziness
d) Visual problems
e) Nosebleeds (Epistaxis)
f) Irregular Heartbeat (Arrhythmia)
g) Swelling (Edema)
h) Chest Discomfort
 Etiology of hypertension
Primary hypertension Secondary hypertension
Genetic Hormonal disease
Age Kidney disease
Gender Pregnancy
Obesity Medication
Lifestyle Thyroid problem
Stress Diabetes
Diet High cholesterol

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 Pathophysiology of Hypertension
• Several physiological mechanisms are involved in the maintenance of normal
blood pressure, and their derangement may play a part in the management of
essential hypertension.
• Factors that have been responsible for the development of essential hypertension
are- salt intake, insulin resistance, obesity, the renin-angiotensin system, and the
sympathetic nervous system.

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 Non-Pharmacological management

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1. Calcium channel blockers: block the calcium channels in the myocardium and thereby
reduce the contractility of the myocardium. Ex- Phenylethylamine, Benzothiazepine,
Dihydropyridines.
2. Vasodilators: reduce blood pressure by vasodilation. Ex- Sodium Nitroprusside,
Hydralazine, Minoxidil, Fenoldopam, Diazoxide.
3. Diuretics: diuretics cause diuresis and reduce the ECF volume and blood volume. Ex-
Hydrochlorothiazide, Furosemides, Spironolactone.
4. Angiotensin-converting enzyme inhibitors (ACE inhibitors): reduces blood pressure by
blocking the formation of angiotensin. Ex- Captopril, Enalapril.
 Pharmacological management

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5. Angiotensin (AT1) receptor blocker: Ex- Losartan, Telmisartan, Valsartan.
6. Sympathetic inhibitors
a) Alpha Beta-adrenergic blockers—Labetalol, Carvedilol.
b) α adrenergic blockers— Prazosin, Doxazosin, Phenoxybenzamine.
c) β adrenergic blockers— Atenolol, Metoprolol, Propranolol.
d) Central sympatholytic— Methyldopa, Reserpine, Clonidine.

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