An Overview on Therapeutics of Hypertension

Overview

This material describes an interaction between a patient, Mr AA and a clinical pharmacist. Mr. AA, a 55 year old obese man, visits his general practitioner for a monthly review and is diagnosed with hypertension. He is very worried because his uncle died of hypertension recently and wants to know much about hypertension hence the GP refers him to a clinical pharmacist. The pharmacist then describes the causes, risk factors, symptoms, investigations and ways of managing hypertension to Mr. AA to reassure him that there is no need to worry, his condition can be managed effectively.

Author(s): Mrs. Afia MarfoView Details of Author
Year: 2011
Keywords: therapuetics, hypertension, social pharmacy, management 
Licensing Condition:

cc-by-nc© 2011, KNUST

Unless otherwise noted, the content of this programme is licensed under the terms of a Creative Commons Attribution-NonCommercial 3.0 Unported License.

Disclaimer

 

Any information and/or video demonstration in this material is intended to inform and to educate and is not a tool for self-diagnosis or a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional. You should speak to your lecturer, healthcare professional or lab technician and make an appointment, if you have questions or concerns about this information.

 

Viewer discretion is advised. The educational material contained herein may contain medical images that non-professional viewers may find disturbing.

All characters appearing in the video are fictitious. Any resemblance to real persons, living or dead, is purely coincidental. Images used here have been tagged attribution, under the creative commons licensing.

 

Note: You assume all responsibility for use and potential liability associated with any use of the material. Material contains copyrighted content, used in accordance with Ghanaian law. Copyright holders of content included in this material should contact the authors with any questions, corrections, or clarifications regarding the use of content. The copyright holders for this programme do not license the use of third party content posted to this site unless such a license is specifically granted in connection with particular content. Users of content are responsible for their compliance with applicable law.

 

Introduction

 

Currently cardiovascular diseases are on the increase in Ghana. Hypertension is one common cardiovascular disease that is commonly reported in hospitals in the urban centers such as Accra and Kumasi in Ghana.  Hypertension can be defined as persistent high blood pressure of more than 140/90mmHg on at least two different occasions. The causes of essential hypertension are unknown but some risk factors are smoking, sedentary life style and obesity.  Diagnosis of hypertension is normally done at the hospital or clinic by measuring the blood pressure since hypertension does not often present any symptoms. The main goals for the management of hypertension include:

 

To treat hypertension adequately to reduce the risk of cardiovascular morbidity and mortality

To identify other cardiovascular risk factors and manage them appropriately.

 

The management of hypertension involves medicines such as diuretics, calcium channel blockers and angiotensin converting enzyme inhibitors. Beta Blocks can also be used for the management of hypertension but it is not the first choice because apart from reducing the blood pressure it does not offer other benefits such as preventing some complications of hypertension. The management follows an add-on therapy procedure where normally one drug is given first and if the hypertension is not adequately controlled another medication is added.  Pharmacists play very essential roles in the management of hypertension. These include making recommendations on therapy for hypertensive patients, monitoring antihypertensive therapy, counselling patients on the usage of antihypertensives and life style modification and providing evidence based guidelines on the management of hypertension.

 

Objectives

 

Describe the causes and risk factors of hypertension

Explain the diagnosis of hypertension

Describe the signs and symptoms of hypertension

Choose appropriate therapy for management of hypertension

Counsel patients on lifestyle modifications for the management of hypertension

 

Lesson Content

 

An Overview on Therapeutics of Hypertension (video)
An Overview on Therapeutics of Hypertension

 

 

Self Assessment Quiz

 

Introduction

In the following questions, there are two statements that may be True or False. Some of the statements may be true and related, whilst others may both be true but unrelated or both false.

 

Use the letters: A,B,C,D or E as your answer to the questions.

A – Both statements are true and related

B – Both statements are true but unrelated

C – The first statement is true but the second statement is false

D – The first statement is false but the second statement is true

E – Both statements are false

 

Questions

   1. The crude prevalence of hypertension in Ghana is 28.8% because hypertension is one of the top five conditions reported at health centers in the Greater Accra and Ashanti Region.

 

   2. Smoking is a risk factor for essential hypertension because nicotine present in tobacco increases oxygen supply to other parts of the body.

 

   3. Long term use of corticosteroids is a secondary cause of hypertension because Corticosteroids cause salt and water retention.

 

   4. A decrease in the total resistance to blood provided by the entire vascular system with no change in cardiac output would increase the blood pressure because increased blood pressure is frequently caused by an increase in total peripheral resistance.

 

   5. No antihypertensive drug is indicated for the management of prehypertension because prehypertension is when the diastolic blood pressure is between 90 and 99.

 

   6. Age is a factor that influences the choice of antihypertensive medication because age is a risk factor for hypertension.

 

   7. ACE inhibitors are contraindicated in women who are breastfeeding older infants because ACE inhibitors are associated with profound neonatal hypotension.

 

   8. In the management of hypertension low doses should be recommended for the elderly because the elderly are more prone to adverse effects.

 

   9. Patients starting ACE inhibitors at home should be advised to take the first dose at bed time because ACE inhibitors are associated with cough.

 

  10. Sleep disturbances or nightmare can occur as side effects in patients prescribed atenolol because atenolol is lipid soluble and crosses the blood brain barrier.

 

  11. Beta blockers should be prescribed with caution in patients with diabetes because the warning signs of hypoglycemia can be masked by non selective beta-blockers.

 

  12. Unduly high blood pressure must be controlled before low dose of Aspirin (75mg) is prescribed for primary prevention of cardiovascular events in hypertensive patients because there is an increased risk of hemorrhagic stroke when Aspirin is given to patients with unduly high blood pressure.

 

  13. Thiazide diuretics are contraindicated in pregnant women because the use of diuretics in the third trimester may result in the development of neonatal thrombocytopenia.

 

     Click here for the answers...

 

 

 

References

     

    Below are supplementary reading materials provided under this course:

     

Credits

 

Author
afia marfo

Mrs. Afia Marfo
Department of Clinical and Social Pharmacy
College of Health Sciences, KNUST
Kumasi, Ghana

Student Volunteers
douglas baiden

Douglas Baiden
Department of Communication Design, KNUST
Kumasi, Ghana

ezekiel quaicoo

Ezekiel Qauicoo
Department of Communication Design, KNUST
Kumasi, Ghana

Technical Support

Samuel Owusu Agyeman-Duah
Media Specialist
KNUST, Kumasi - Ghana
trexzone@yahoo.co.uk

Benjamin Prempeh
Media Specialist
KNUST, Kumasi - Ghana
adobrog@yahoo.com

Moro Ismailah
Dept. of Communication Design
KNUST, Kumasi - Ghana
ismor.ideas@yahoo.com

Voice Over
anne acquaah

Anne Acquaah
Kumasi, Ghana

 

Acknowledgment

 

This programme was produced with support from the following:

acknow-logo