Practical management of hypertension in adults
Abstract
Hypertension is the most powerful, independent, preventable risk factor for death and disability from cardiovascular diseases. Initial clinical assessment and diagnostic testing are essential to disclose; (a) secondary causes to avoid resistant cases that needs specific therapy, (b) co-morbid conditions that limits choice of drug-therapy, and (c) target organ damage that dictates specialized approach. In this review article; an algorithm for its management is outlined that includes also specific practical approach to those with emergencies, urgencies and co-morbid conditions.
Keywords: adults, coronary artery disease, heart failure, hypertension, renal failure, stroke.
Keywords:
adults, coronary artery disease, heart failure, hypertension, renal failure, stroke
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References
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14- Hsu FY, Lin FJ, Ou HT, Huang SH, Wang CC. Renoprotective Effect of Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers in Diabetic Patients with Proteinuria. Kidney Blood Press Res. 2017; 42:358-368. https://doi.org/10.1159/000477946
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17- Al Khaja KAJ, Sequeira RP, Alkhaja AK, et al. Antihypertensive drugs and male sexual dysfunction: a review of adult hypertension guideline recommendations. J Cardiovasc Pharmacol Ther. 2016; 21:233-244. https://doi.org/10.1177/1074248415598321
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21- Committee on Obstetric Practice. Committee Opinion No. 692: Emergent Therapy for Acute-Onset, Severe Hypertension During Pregnancy and the Postpartum Period. Obstet Gynecol. 2017; 129:e90-e95. https://doi.org/10.1097/AOG.0000000000002019
22- Nienaber CA, Powell JT. Management of acute aortic syndromes. Eur Heart J. 2012; 33:26-35b. https://doi.org/10.1093/eurheartj/ehr186
23- Lenders JW, Duh QY, Eisenhofer G, Gimenez-Roqueplo AP, Grebe SK, et al. Pheochromocytoma and paraganglioma: an endocrine society clinical practice guideline, J Clin Endocrinol Metab. 2014; 99:1915-1942. https://doi.org/10.1210/jc.2014-1498
24- Mazza A, Beltramello G, Armigliato M, Montemurro D, Zorzan S, Zuin M, Rampin L, Marzola MC, Grassetto G, Al-Nahhas A, Rubello D. Arterial hypertension and thyroid disorders: what is important to know in clinical practice? Ann Endocrinol (Paris). 2011; 72:296-303. https://doi.org/10.1016/j.ando.2011.05.004
25- Cooper WO, Hernandez-Diaz S, Arbogast PG, Dudley JA, Dyer S, Gideon PS, Hall K, Ray WA. Major congenital malformations after first-trimester exposure to ACE inhibitors. N Engl J Med. 2006; 354:2443-2451. https://doi.org/10.1056/NEJMoa055202
26- Bateman BT, Patorno E, Desai RJ, Seely EW, Mogun H, Dejene SZ, Fischer MA, Friedman AM, Hernandez-Diaz S, Huybrechts KF. Angiotensin-Converting Enzyme Inhibitors and the Risk of Congenital Malformations. Obstet Gynecol. 2017; 129:174-184. https://doi.org/10.1097/AOG.0000000000001775
27- Brown CM, Garovic VD. Drug treatment of hypertension in pregnancy. Drugs. 2014; 74:283-296. https://doi.org/10.1007/s40265-014-0187-7
28- Drug record: Diuretics. National Institutes of Health. https://livertox.nlm.nih.gov/Diuretics.htm. Accessed June 25, 2019.
29- Piller LB, Simpson LM, Baraniuk S, et al. Characteristics and long term follow-up of participants with peripheral arterial disease during ALLHAT. J Gen Intern. Med. 2014; 29:1475-1483. https://doi.org/10.1007/s11606-014-2947-1
2- Houston MC. Hypertension strategies for therapeutic intervention and prevention of end-organ damage. Prim Care 1991; 18:713-753. https://doi.org/10.1016/S0095-4543(21)00355-9
3- WHO fact sheets, 17th May 2021.
4- El-Reshaid K, Al-Owaish R, Diab A. Hypertension in Kuwait: The past, present and future. SJKDT. 1999; 10: 357-364.
5- El-Reshaid K. B-mode gray-scale ultrasound abnormalities in adult patients: A useful tool in diagnosis of kidney diseases. JDDT. 2021; 11:97-102. https://doi.org/10.22270/jddt.v11i3.4698
6- El-Reshaid K, Al-Bader S. Bilateral adrenal hyperplasia; a common cause of drug-refractory hypertension yet amenable to medical treatment. JDDT 2020; 10(1-s):79-82. https://doi.org/10.22270/jddt.v10i1-s.3862
7- Lenders JW, Duh QY, Eisenhofer G, et al. Pheochromocytoma and paraganglioma: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2014; 99:1915-42. https://doi.org/10.1210/jc.2014-1498
8- El-Reshaid K, Al-Bader S, New regimen for treatment of irritable bowel syndrome with emphasis on Sulpride as the sole maintenance therapy. JDDT. 2019; 9:154-157. https://doi.org/10.22270/jddt.v9i5.3424
9- Mills, K.T., Stefanescu, A. & He, J. The global epidemiology of hypertension. Nat Rev Nephrol. 2020; 16:223-237. https://doi.org/10.1038/s41581-019-0244-2
10- Helmer A, Slater N, Smithgall S. A Review of ACE Inhibitors and ARBs in Black Patients with Hypertension. Ann Pharmacother. 2018; 52: 1143-1151. https://doi.org/10.1177/1060028018779082
11- Vongpatanasin W. Resistant hypertension: a review of diagnosis and management. JAMA. 2014; 311:2216-2224. https://doi.org/10.1001/jama.2014.5180
12- El-Reshaid K and Al-Bader S. Sequential Combination Diuretic-Therapy for Massive Fluid Overload in Furosemide-Refractory Patients with Diabetic Kidney Disease. Open J Nephrol. 2021; 11:265-272.
13- Nazarzadeh M, Pinho-Gomes AC, Rahimi K. Resistant hypertension in times of changing definitions and treatment recommendations. Heart. 2019; 105:96-97. https://doi.org/10.1136/heartjnl-2018-313786
14- Hsu FY, Lin FJ, Ou HT, Huang SH, Wang CC. Renoprotective Effect of Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers in Diabetic Patients with Proteinuria. Kidney Blood Press Res. 2017; 42:358-368. https://doi.org/10.1159/000477946
15- Kidney Disease: Improving Global Outcomes (KDIGO) Blood Pressure Work Group. KDIGO 2021 clinical practice guideline for the management of blood pressure in chronic kidney disease. 2021; 99:S1-S87. https://doi.org/10.1016/j.kint.2020.11.003
16- Diercks DB, Ohman EM. Hypertension with acute coronary syndrome and heart failure. Ann Emerg Med. 2008; 51: (3 Suppl):S34-36. https://doi.org/10.1016/j.annemergmed.2007.11.012
17- Al Khaja KAJ, Sequeira RP, Alkhaja AK, et al. Antihypertensive drugs and male sexual dysfunction: a review of adult hypertension guideline recommendations. J Cardiovasc Pharmacol Ther. 2016; 21:233-244. https://doi.org/10.1177/1074248415598321
18- Morris AA, Page RL 2nd, Baumgartner LJ, Mueller SW, MacLaren R, Fish DN, Kiser TH. Thiocyanate Accumulation in Critically Ill Patients Receiving Nitroprusside Infusions. J Intensive Care Med. 2017; 32:547-553. https://doi.org/10.1177/0885066616657004
19- Varon J. Diagnosis and management of labile blood pressure during acute cerebrovascular accidents and other hypertensive crises. Am J Emergency Med 2007; 25:949-959. https://doi.org/10.1016/j.ajem.2007.02.032
20- Odigboegwu O, Pan LJ, Chatterjee P. Use of Antihypertensive Drugs During Preeclampsia. Front Cardiovasc Med. 2018; 5:50. https://doi.org/10.3389/fcvm.2018.00050
21- Committee on Obstetric Practice. Committee Opinion No. 692: Emergent Therapy for Acute-Onset, Severe Hypertension During Pregnancy and the Postpartum Period. Obstet Gynecol. 2017; 129:e90-e95. https://doi.org/10.1097/AOG.0000000000002019
22- Nienaber CA, Powell JT. Management of acute aortic syndromes. Eur Heart J. 2012; 33:26-35b. https://doi.org/10.1093/eurheartj/ehr186
23- Lenders JW, Duh QY, Eisenhofer G, Gimenez-Roqueplo AP, Grebe SK, et al. Pheochromocytoma and paraganglioma: an endocrine society clinical practice guideline, J Clin Endocrinol Metab. 2014; 99:1915-1942. https://doi.org/10.1210/jc.2014-1498
24- Mazza A, Beltramello G, Armigliato M, Montemurro D, Zorzan S, Zuin M, Rampin L, Marzola MC, Grassetto G, Al-Nahhas A, Rubello D. Arterial hypertension and thyroid disorders: what is important to know in clinical practice? Ann Endocrinol (Paris). 2011; 72:296-303. https://doi.org/10.1016/j.ando.2011.05.004
25- Cooper WO, Hernandez-Diaz S, Arbogast PG, Dudley JA, Dyer S, Gideon PS, Hall K, Ray WA. Major congenital malformations after first-trimester exposure to ACE inhibitors. N Engl J Med. 2006; 354:2443-2451. https://doi.org/10.1056/NEJMoa055202
26- Bateman BT, Patorno E, Desai RJ, Seely EW, Mogun H, Dejene SZ, Fischer MA, Friedman AM, Hernandez-Diaz S, Huybrechts KF. Angiotensin-Converting Enzyme Inhibitors and the Risk of Congenital Malformations. Obstet Gynecol. 2017; 129:174-184. https://doi.org/10.1097/AOG.0000000000001775
27- Brown CM, Garovic VD. Drug treatment of hypertension in pregnancy. Drugs. 2014; 74:283-296. https://doi.org/10.1007/s40265-014-0187-7
28- Drug record: Diuretics. National Institutes of Health. https://livertox.nlm.nih.gov/Diuretics.htm. Accessed June 25, 2019.
29- Piller LB, Simpson LM, Baraniuk S, et al. Characteristics and long term follow-up of participants with peripheral arterial disease during ALLHAT. J Gen Intern. Med. 2014; 29:1475-1483. https://doi.org/10.1007/s11606-014-2947-1
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El-Reshaid K. Practical management of hypertension in adults. JDDT [Internet]. 15Sep.2021 [cited 17Apr.2024];11(5):131-5. Available from: https://jddtonline.info/index.php/jddt/article/view/4986
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