NSG6005 Pathophysiology of Essential Hypertension
1. Pathophysiology of Essential Hypertension.
2. Definition of calcium channel blockers
3. Definition of diuretics
4. What is the mechanism of action of hydrochlorothiazide and spironolactone, and lisinopril and their pharmacokinetics
Pathophysiology of Essential Hypertension
Essential hypertension is caused by many highly complex and multifactorial processes. In essential hypertension, the kidney becomes both the target organ and the contributing factor to hypertensive processes. Numerous factors will play a vital role in the pathogenesis of hypertension, including activation of the neurohormonal systems such as the renin-angiotensin-aldosterone system, the sympathetic nervous system, genetics, increased dietary salt intake, and obesity (Taddei et al., 2018). All these factors may contribute to the onset of arterial hypertension, which is the systemic elevation of blood pressure. During its natural history, essential hypertension will progress from being randomly occurring hypertension to an established form of hypertension (Taddei et al., 2018).
Definition of ACE Inhibitors
ACE inhibitors are medications that help relax the arteries and veins to effectively lower a patient’s blood pressure. ACE inhibitors work by preventing the production of angiotensin II, which is the enzyme responsible for the narrowing of blood vessels (Saxena et al., 2018).
Definition of Diuretics
Diuretics are medications that are administered to increase the amount of water released from a patient’s body through their urine. Diuretics are normally administered to patients to treat edema (Saxena et al., 2018).
Mechanism of Action of Hydrochlorothiazide, Spironolactone, and Lisinopril
Hydrochlorothiazide inhibits the sodium chloride co-transporter system on the distal convoluted tubules. This eventually results in diuretic action, which will lower the blood pressure of a patient (Rahimi et al., 2021).
On the other hand, Spironolactone acts in the distal convoluted renal tubule by enhancing the competitive binding of receptors in the aldosterone-dependent sodium-potassium exchange site. Spironolactone prevents the body from absorbing too much salt (Rahimi et al., 2021).
Lisinopril acts by inhibiting ACE, which is the enzyme responsible for narrowing blood vessels. Eventually, Lisinopril helps relax the arteries and veins and lower the blood pressure of a patient (Rahimi et al., 2021).
- Rahimi, K., Bidel, Z., Nazarzadeh, M., Copland, E., Canoy, D., Ramakrishnan, R., Pinho-Gomes, A. C., Woodward, M., Adler, A., Agodoa, L., Algra, A., Asselbergs, F. W., Beckett, N. S., Berge, E., Black, H., Brouwers, F. P. J., Brown, M., Bulpitt, C. J., Byington, R. P., . . . Davis, B. R. (2021). Pharmacological blood pressure lowering for primary and secondary prevention of cardiovascular disease across different levels of blood pressure: an individual participant-level data meta-analysis. The Lancet, 397(10285), 1625–1636. https://doi.org/10.1016/s0140-6736(21)00590-0
- Saxena, T., Ali, A. O., & Saxena, M. (2018). Pathophysiology of essential hypertension: an update. Expert Review of Cardiovascular Therapy, 16(12), 879–887. https://doi.org/10.1080/14779072.2018.1540301
- Taddei, S., Bruno, R. M., Masi, S., & Solini, A. (2018). Epidemiology and pathophysiology of hypertension. ESC CardioMed, 2377–2388. https://doi.org/10.1093/med/9780198784906.003.0563_update_001