Cardiovascular Medicine Book

Approach

Causes

Evaluation

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Management

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Hypertension Management for Specific Comorbid DiseasesAka: AntiHypertensives for Specific Comorbid Diseases

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  1. See Also
    1. Hypertension
    2. Hypertension Criteria
    3. Hypertension Evaluation
    4. Hypertension Management
    5. Antihypertensive Selection
    6. Hypertension Management for Specific Populations
    7. Isolated Systolic Hypertension
  2. Diabetes Mellitus (with or without Diabetic Nephropathy)
    1. See Hypertension in Diabetes Mellitus
  3. Left Ventricular Hypertrophy (Risk of sudden death)
    1. Central active agonists
    2. ACE Inhibitors
    3. Calcium Channel Blockers
  4. Congestive Heart Failure
    1. Systolic Dysfunction
      1. ACE Inhibitor
      2. Angiotensin Receptor Blocker
      3. Diuretic
      4. Beta Blocker (use with caution, CIBIS II, MERIT-HF)
        1. High efficacy with Carvedilol
      5. Spironolactone (use with caution, RALES trial)
    2. Diastolic Dysyfunction
      1. Calcium Channel Blocker
  5. Coronary Artery Disease risk or Myocardial Infarction
    1. General
      1. Beta Blocker
      2. ACE Inhibitor (HOPE trial)
    2. Angina
      1. Beta Blockers
      2. Calcium Channel Blockers (Not Nifedipine)
  6. Atrial Tachycardia and Atrial Fibrillation
    1. Beta Blockers
    2. Nondihydropyridine calcium antagonists
  7. Benign Prostatic Hyperplasia
    1. Alpha antagonist
    2. Avoid Diuretics
  8. Dyslipidemia
    1. Alpha antagonists
    2. Diuretics do not worsen Hyperlipidemia
    3. Beta Blockers do not worsen Hyperlipidemia
  9. Renal Disease
    1. ACE Inhibitor
    2. Diuretic
  10. Pregnancy
    1. Methyldopa
    2. Hydralazine
    3. Labetolol
    4. Do not use ACE Inhibitor
  11. Obesity
    1. Diuretics
  12. Gout
    1. Avoid Thiazide Diuretics
  13. Osteoporosis
    1. Thiazide Diuretics (may prevent Hip Fractures)
  14. Obstructive Pulmonary Disease (COPD or Asthma)
    1. Avoid Beta Blockers
  15. Perioperative Hypertension
    1. Beta Blockers should be use preventively
    2. Delay surgery until BP <180/110
  16. Edema
    1. Avoid Calcium Channel Blockers
  17. Peripheral Vascular Disease
    1. These patients are high risk for cardiovascular event
    2. Calcium Channel Blocker
    3. Beta Blockers may be tolerated
      1. Previously thought to be contraindicated
  18. Peptic Ulcer Disease
    1. Avoid Calcium Channel Blockers
    2. Gastrointestinal Bleeding risk
  19. Neurologic and psychiatric disorders
    1. Essential Tremor
      1. Noncardioselective Beta Blocker
    2. Migraine Headache
      1. Noncardioselective Beta-Blockers
      2. Nondihydropyridine calcium antagonists
    3. Major Depression
      1. Avoid Beta Blockers
    4. Substance Abuse
      1. Labetolol (Combined alpha-Beta Blocker)
      2. Calcium Channel Blockers
      3. Nitrates

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