Cardiovascular Medicine Book

Approach

Causes

Evaluation

Information Resources

Management

Miscellaneous

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Hypertension Management for Specific PopulationsAka: Antihypertensives for Specific Populations

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  1. See Also
    1. Hypertension
    2. Hypertension Criteria
    3. Hypertension Evaluation
    4. Hypertension Management
    5. Antihypertensive Selection
    6. Isolated Systolic Hypertension
    7. Hypertension in Athletes
    8. Hypertension Management for Specific Comorbid Diseases
    9. Anti-Hypertensive Medications in Pregnancy
    10. Hypertension in Infants
  2. Young Hypertensive
    1. Pathophysiology
      1. Active
      2. Increased sympathetic tone
      3. Elevated PRA
    2. First choice medications
      1. ACE Inhibitor
    3. Other medications
      1. Beta-alpha antagonist
      2. Alpha-1 antagonist
      3. Calcium Channel Blocker
    4. Avoid
      1. Beta Blockers
        1. Decreased HDL
        2. Sex and Exercise affected
  3. Athletes
    1. See Hypertension in Athletes
  4. Elderly
    1. See Hypertension in the Elderly
  5. Black Ethnicity
    1. Pathophysiology
      1. Low renin
      2. High plasma volume
      3. High vessel resistance
    2. First Choice Medications
      1. Diuretics (Hydrochlorothizides)
        1. Concurrent use improves Beta Blocker response
        2. Concurrent use improves ACE Inhibitor response
      2. Calcium Channel Blockers
    3. Changes (Previously contraindicated)
      1. ACE Inhibitors
        1. Previously thought not useful with low renin status
        2. Use if indicated for renal protection (however, will require additional antihypertensive)
        3. AASK study showed benefit with Ramipril
          1. Retarded renal disease progression
          2. Wright (2002) JAMA 288:2421
    4. Other Medications
      1. Labetalol
  6. Obesity (even 10 pounds or 4.5 kg over Ideal Weight)
    1. Pathophysiology
      1. Modestly elevated vessel resistance
      2. Higher Cardiac output
      3. High plasma volume
      4. Low renin
    2. First Choice Management
      1. Weight Reduction
      2. Diuretics

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