ACEI/ARBS in HTN: First line drug after ______. If patient is also DM, should be on ACEI or ARB as _________.
first line therapy
EBR have shown that ARBS/ACEI are highly beneficial--
Improve O2 to heart
Decrease cardiac remodeling
ARBS/ACEI adverse effects:
• Hypotension‐worst with first dose‐give at
• Worsening renal function
• Hyperkalemia‐monitor K+
• Angioedema and cough (ACEI) (higher in black
and Asian patients)
• Rash, neutropenia
• Antihypertensive response is reduced by NSAIDS
• Intolerance‐angioedema, anuric renal failure
• Bilateral renal artery stenosis
• Pregnancy‐category D
• Renal insuffiency (creatinine >3mg/dl)
• Hyperkalemia (>5.5)
• Severe hypotension
B-Adrenergic Blockers: How do they work?
Beta blockers have effects on beta-1-cardiac and beta-2 bronchial and smooth muscle receptors
B-adrenergic blockers: How do they work?
Beta 1 blockade decreases heart rate and myocardial activity during periods of high sympathetic activity, which decreases cardiac output, which decreases BP. The blockade also suppresses automaticity resulting in decreased oxygen demand.