L27 Therapeutics of Hypertension

Hypertension is very common, with a prevalence ❌% in adults. It is more common with age, Maori and PI ethnicity, in younger men, older women, in the obese, those with a ❌ lifestyle, high fat/salt/sugar diet, and caffeine/nicotine/alcohol intake. There is a ❌% mortality in patients with uncontrolled hypertension.

Stage one (mild) hypertension: a clinic BP measurement of ≥❌ mmHg, or an average daytime ambulatory BP of ≥❌ mmHg.
Stage two (moderate) hypertension: a clinic BP of ≥❌ mmHg, or an average daytime ambulatory BP of ≥❌ mmHg.
Severe hypertension: a systolic pressure of ≥❌ mmHg, or a diastolic pressure of ≥❌ mmHg.

Principles of HTN treatment include lifestyle changes, ❌ to cause vasodilation, to assess (❌) 5-year cardiovascular risk, and to modify/reduce CV risks.
Goals of treatment:
- Prevent, or ❌ the progress, of organ ❌ and complications
- Provide ❌ treatment in terms of dose, dosing schedule, combination therapy, and adverse effects
- Optimise ❌
Target BP is < ❌ mmHg for most people, < ❌ mmHg for patients with chronic kidney disease (CKD), diabetes, or established cardiovascular disease.

Treatment steps:
- Start with ❌. Use ❌ if contraindicated or if ACEI causes cough.
- Add a ❌ to ACEI or ARB.
- Add a ❌

In diabetics: ACEI is first line as it’s ❌.
In IHD or AF patients: include a beta-blocker early as it's ❌
In HF patients: include a ❌ dose beta-blocker
Check ❌ and ❌ effects at each step.