Hypertension Physiology, Pathophysiology, Pharmacology, Therapeutics

1. Hypertension
Mr. Jaineel Dharod(JD)
Asst. Professor, Dept. of Pharmacology

2. Introduction
• Leading risk factor for severe cardiovascular
diseases.
• It can be serious if not managed properly.
• Modern lifestyle has become an important
etiological factor for hypertension.
• Obesity, Stress, Alcohol can lead to
Hypertension.

3. Types of Hypertension
1. Primary: Caused due to primary etiological
factors.
2. Secondary: Caused as a side effect of any drug
or any disease condition.
3. Gestational: Rise in BP during pregnancy.

4. Diagnosis
• As Per JNC-7 Classification
Systolic/diastolic
pressure (mm Hg)
Category
< 120/80 Normal
120-135/80-98 prehypertension
≥ 140/90 Hypertension
140-159/90-99 Stage 1
≥ 160/100 Stage 2

5. Diagnosis
• As Per JNC-8 Classification
https://www.ajmc.com/journals/evidence-based-diabetes-management/2014/january-
2014/the-jnc-8-hypertension-guidelines-an-in-depth-guide

6. Etiology
• Stress
• Alcohol
• Sedentary Lifestyle
• Obesity
• Medications
• Genetic factors
• Environmental factors
• Dietary style
• Salt Intake
• Age

7. Pathophysiology

8. When Low Blood Pressure
β1 Receptor on heart wall
activation
α1 Receptor on blood
vessels activation
Heart Rate & Cardiac
output increase
Peripheral Vascular
resistance increase
β1 Receptor in kidney
cells activation
Renin release
Angiotensinogen Angiotensin 1
Angiotensin 2
ACE
Angiotensin
Receptor activation
PVR increase
BP increase
Aldosterone release
Na+, H2O retention in
blood vessel
Increase in blood
volume
Cardiac Output
increase
Vasomotor centre

9. Pharmacotherapy
Easy Management

10. β-blockers
Propranolol
Atenolol
α-blockers
Prazosin
Terazosin
Alfuzosin
α-β mix
blockers
Carvedilol
Labetalol
Central
Sympatholytic
Clonidine
α Methyl-DOPA
Ganglion
Blockers
Guanithidine
Trimethophan

11. Renin
Inhibitors
Aliskiren
Kalikiren
ACE
Inhibitors
Ramipril
Lisinopril
Enalapril
AT Receptor
Blockers (ARB)
Losartan
Candesartan
Irbesartan
Aldosterone
Receptor
Blockers
Spironolactone
Eplerenone
Renin
Release
Blockers
Propranolol

12. Diuretics
Chlorthiazide
Furosemide
Bumetanide
Ethacrynic acid
Amiloride
Hydrochlorothiazide
Acetazolamide
Vasodilator
Sodium Nitroprusside
Minoxidil
Nitric Oxide
Calcium Channel
Blockers
Nifedipine
Amlodipine
Verapamil
Diltiazem

13. Difficult Management
• Controlled Diet
• Exercise
• Stress management
• Drink Water
• No Alcohol
• No Burgers and Pizza
• Low salt food
Lifestyle Modification

14. THANK
YOU
STAY CHILLED & SAY NO TO
HYPERTENSION