What is Hypertension?

Hypertension is also known as high blood pressure. It is defined as transitory (short-lived) or chronic elevation of the blood pressure in the arteries. This elevation may lead to cardiovascular damage.




Blood pressure is broken into systolic and diastolic values. The systolic measurement is the peak pressure in the arteries, and the diastolic measurement is the minimum pressure in the arteries. Normal blood pressure is below 120/80, where 120 represents the systolic (maximum) measurement and 80 represents the diastolic (minimum) measurement. 

Hypertension occurs when the blood pressure reaches above 140/90. The risk for hypertension is increased in a condition known as prehypertension, which occurs when the blood pressure is between 120/80 and 139/89.

Definition
An untreated systolic blood pressure (BP) of 140 mmHg or higher or a diastolic BP of 90 mmHg or higher, taking antihypertensive medications or being told at least twice by a physician or other health professional that you have high blood pressure

Findings
  • Increased blood pressure

Causes of Hypertension
The most common causes of hypertension include 
  • Smoking, 
  • Obesity or being overweight, 
  • Diabetes, 
  • Having a sedentary lifestyle, 
  • Lack of physical activity, 
  • High salt or alcohol intake levels, 
  • Insufficient consumption of calcium, potassium or magnesium, 
  • A deficiency in vitamin D, 
  • Stress, 
  • Aging, 
  • Chronic kidney disease and adrenal and thyroid conditions or tumors. 
  • Some individuals may also be genetically predisposed to hypertension.

Treatment

Thiazide Diuretics

CHLOROTHIAZIDE
Adults: 125 to 500 mg orally once or in 2 divided doses daily.

CHLORTHALIDONE
Adults: 12.5 to 25 mg (generic) orally once daily.

HYDROCHLOROTHIAZIDE
Adults: 12.5 to 50 mg orally once daily.

POLYTHIAZIDE
Adults: 2 to 4 mg orally once daily

INDAPAMIDE
Adults: initial dose 1.25 mg orally daily; titrate every 4 weeks to the desired effect; maintenance dose 2.5 to 5 mg daily

METOLAZONE
Adults: 0.5 to 1 mg (Mykrox) orally once daily


Loop Diuretics

BUMETANIDE
Adults: 0.5 to 2 mg orally in 2 divided doses daily

FUROSEMIDE
Adults: 20 to 80 mg orally in 2 divided doses daily

TORSEMIDE
Adults: 2.5 to 10 mg orally once daily


Potassium-Sparing Diuretics

AMILORIDE HYDROCHLORIDE
Adults: 5 to 10 mg orally in 1 or 2 divided doses daily

TRIAMTERENE
Adults: 50 to 100 mg orally in 1 or 2 divided doses daily


ACE Inhibitor

BENAZEPRIL HYDROCHLORIDE
Adults: 10 to 40 mg orally once daily

CAPTOPRIL
Adults: 25 to 100 mg orally in divided doses twice daily

ENALAPRIL MALEATE
Adults: 5 to 40 mg orally once daily or in divided doses twice daily

FOSINOPRIL SODIUM
Adults: 10 to 40 mg orally once daily

LISINOPRIL
Adults: 10 to 40 mg orally once daily

MOEXIPRIL HYDROCHLORIDE
Adults: 7.5 to 30 mg orally once daily

PERINDOPRIL ERBUMINE
Adults: 4 to 8 mg orally once daily

QUINAPRIL HYDROCHLORIDE
Adults: 10 to 80 mg orally once daily

RAMIPRIL
Adults: 2.5 to 20 mg orally in 1 or 2 divided doses daily

TRANDOLAPRIL
Adults: 1 to 4 mg orally once daily


Aldosterone Receptor Blocker

EPLERENONE
Adults: 50 to 100 mg orally once daily

SPIRONOLACTONE
Adults: 25 to 50 mg orally once daily


Beta-Blocker

ACEBUTOLOL HYDROCHLORIDE
Adults: 200 to 800 mg orally in divided doses twice daily

ATENOLOL
Adults: 25 to 100 mg orally once daily

BETAXOLOL HYDROCHLORIDE
Adults: 5 to 20 mg orally once daily

BISOPROLOL FUMARATE
Adults: 2.5 to 10 mg orally once daily

METOPROLOL TARTRATE
Adults: initial dose 100 mg orally daily in single or divided doses taken with or immediately following meals; increase dose weekly until optimal blood pressure reduction is achieved; effective dosage range 100 to 450 mg orally daily

NADOLOL
Adults: 40 to 120 mg orally once daily

PENBUTOLOL SULFATE
Adults: 10 to 40 mg orally once daily

PINDOLOL
Adults: 10 to 40 mg orally in 2 divided doses daily

PROPRANOLOL HYDROCHLORIDE
Adults: 60 to 180 mg (sustained-release) orally once daily

TIMOLOL
Adults: initial dose 10 mg orally twice daily; titrate to the desired effect based on heart rate and blood pressure response; allow at least 7 days between dose increases; maintenance dose 20 to 40 mg daily in 2 divided doses; maximum daily dose 60 mg in 2 divided doses


Non-Dihydropyridine Calcium Channel Blocker

DILTIAZEM HYDROCHLORIDE
Adults: 120 to 540 mg (sustained release) orally once daily

VERAPAMIL HYDROCHLORIDE
Adults: 120 to 480 mg (sustained release) orally in 1 or 2 divided doses daily


Dihydropyridine Calcium Channel Blocker

AMLODIPINE BESYLATE
Adults: 2.5 to 10 mg orally once daily

FELODIPINE
Adults: 2.5 to 20 mg orally once daily

ISRADIPINE
Adults: 2.5 to 10 mg orally in 2 divided doses daily

NICARDIPINE HYDROCHLORIDE
Adults: 60 to 120 mg (Cardene SR) orally in 2 divided doses daily


Alpha-Blocker

DOXAZOSIN MESYLATE
Adults: 1 to 16 mg orally once daily

PRAZOSIN HYDROCHLORIDE
Adults: 2 to 20 mg orally in 2 or 3 divided doses daily

TERAZOSIN HYDROCHLORIDE
Adults: 1 to 20 mg orally daily in 1 or 2 divided doses


Combined Alpha-Blocker and Beta-Blocker

CARVEDILOL (Related toxicological information in CARVEDILOL)
Adults: 12.5 to 50 mg orally divided into 2 doses daily

LABETALOL HYDROCHLORIDE
Adults: 200 to 800 mg orally daily in 2 divided doses


Angiotensin II Receptor Blocker/Antagonist

CANDESARTAN CILEXETIL
Adults: 8 to 32 mg orally once daily

EPROSARTAN MESYLATE
Adults: 400 to 800 mg orally in 1 or 2 divided doses daily

IRBESARTAN
Adults: 150 to 300 mg orally once daily

LOSARTAN POTASSIUM
Adults: 25 to 100 mg orally in 1 or 2 divided doses daily

OLMESARTAN MEDOXOMIL
Adults: 20 to 40 mg orally once daily

TELMISARTAN
Adults: 20 to 80 mg orally once daily

VALSARTAN
Adults: 80 to 320 mg orally in 1 or 2 divided doses daily


Central Alpha-2 Agonist or other Centrally-Acting Agent

CLONIDINE
Adults: 0.1 to 0.8 mg tablet orally in 2 divided doses daily OR 0.1 to 0.3 mg patch transdermally once weekly

METHYLDOPA
Adults: initial dose 250 mg orally 2 to 3 times daily in the first 48 hours; titrate at intervals of at least 2 days; maintenance dose 500 to 2000 mg daily in 2 to 4 divided doses; maximum daily dose 3000 mg in divided doses

RESERPINE
Adults: 0.1 to 0.25 mg orally once daily

GUANFACINE HYDROCHLORIDE
Adults: 0.5 to 2 mg orally once daily


Direct Vasodilator

HYDRALAZINE HYDROCHLORIDE
Adults: 50 to 100 mg orally in 2 divided doses daily

MINOXIDIL
Adults: 2.5 to 80 mg orally in 1 or 2 divided doses daily

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