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Hypertension and Teaching Points of Antihypertensive Drugs

Hypertension is a disorder that is characterized by higher-than-normal blood pressure which can result in the formation of more adverse and chronic disorders such as heart attacks and kidney failure. According to Silva et al. (2019), hypertension results in structural and functional changes in the blood vessels which increase arterial stiffness, vascular inflammation, and endothelial dysfunction. The main management of hypertension includes the use of medicinal agents that affect the blood pressure to reduce the heightened blood pressure which is also known as antihypertensive drugs. Silva et al. (2019) acknowledge that the antihypertensive drugs reduce the higher levels of blood pressure by reducing the inflammation and improving the endothelial function. The different antihypertensive drugs that are present on the market have a different level of action that results in reduced blood pressure.

ACE inhibitors are a common hypertension management antihypertensive medicine in the market. According to Herman et al. (2021), ACE inhibitors improve the endothelial function by blocking an angiotensin-converting enzyme that converts angiotensin I to angiotensin II which leads to enhanced natriuresis, lowered blood pressure, and prevention of the remodeling of smooth muscle and cardiac myocytes. The mean arterial and diastolic blood pressure are effectively decreased from the therapeutic action of ACE inhibitors in the body. Silva 2019. (2019) identifies that ARBs can improve endothelial dysfunction and vascular inflammation in hypertension by blocking angiotensin I which results in relaxed blood vessels and reduces blood pressure. 

McNally et al. (2022) acknowledge that diuretics stimulate renin release in the blood by the kidneys which reduce the blood pressure by reducing the level of sodium and water in the body which in turn reduces the amount of water in the blood hence lowering pressure. McKeever and Hamilton (2018) identify that CCB blocks the inward movement of calcium in the heart, vascular smooth muscle, and pancreas which allow the relaxation of the blood vessels in the body and hence reduced blood pressure. Affecting the levels of angiotensin I enzyme, reducing water and sodium levels, and managing the calcium movement are the main therapeutic actions in which antihypertensive drugs work to affect the blood pressure.

Important Teaching Points with Antihypertensive Drugs

The most important teaching point for the patients that are using antihypertensive drugs is medical adherence since positive outcomes are heavily influenced by the behavior of the patient when it comes to adhering to their medical instruction. According to Asgedom et al. (2018), medication adherence remains to be a huge challenge for patients with hypertension which necessitates the need for practitioners to have taught the importance of medication adherence. A healthy lifestyle is also essential in patients that are using antihypertensive medication especially when it comes to factors such as exercising and healthy dieting. Cimminiello (2019) acknowledges that patients with hypertension and under antihypertensive medication must adopt a better living lifestyle to improve the rate of recovery. Teaching the importance of losing weight and exercising for patients with obesity-based hypertension and proper eating is crucial in reducing the prevalence of hypertension and enhancing medical efficiency.

Teaching should also be offered on substances that may cause a negative reaction with the antihypertensive medication and the importance of avoiding them to limit any other disorders. Singh et al. (2020) identify that patients on antihypertensive drugs are advised on limiting their alcohol consumption due to the adverse drug reactions that may occur within the patient’s body. Medicine side effects must also be included in the teaching point for the patient to be aware of what reactions to expect while using the medicine. According to Reeve et al. (2020), antihypertensive drugs can cause dangerous side effects such as dizziness and fatigue. Patients who operate machinery or perform a lot of diving activities should have this teaching point insisted on to reduce the chances of accidents in workplaces due to the medication.

References

Asgedom, S. W., Atey, T. M., & Desse, T. A. (2018). Antihypertensive medication adherence and associated factors among adult hypertensive patients at Jimma University Specialized Hospital, southwest Ethiopia. BMC Research Notes11(1), 1-8. https://doi.org/10.1186/s13104-018-3139-6 

Cimminiello, C. (2019). Never enough recommended. Beyond the AHA/ACC guideline on lifestyle and behavior for cardiovascular prevention. European Journal of Internal Medicine70, 8-9. https://doi.org/10.1016/j.ejim.2019.10.021 

Herman, L. L., Padala, S. A., Annamaraju, P., & Bashir, K. (2021). Angiotensin-converting enzyme inhibitors (ACEI). In StatPearls [Internet]. StatPearls Publishing https://www.ncbi.nlm.nih.gov/books/NBK431051/ 

McNally, R. J., Farukh, B., Chowienczyk, P. J., & Faconti, L. (2022). Effect of diuretics on plasma aldosterone and potassium in primary hypertension: A systematic review and meta‐analysis. British Journal of Clinical Pharmacology88(5), 1964-1977. https://doi.org/10.1111/bcp.15156 

McKeever, R. G., & Hamilton, R. J. (2018). Calcium channel blockers.  In: StatPearls. StatPearls Publishing, Treasure Island (FL) https://europepmc.org/article/nbk/nbk482473 

Reeve, E., Jordan, V., Thompson, W., Sawan, M., Todd, A., Gammie, T. M., … & Gnjidic, D. (2020). Withdrawal of antihypertensive drugs in older people. Cochrane Database of Systematic Reviews, (6). https://doi.org/10.1002/14651858.CD012572 

Silva, I. V. G., de Figueiredo, R. C., & Rios, D. R. A. (2019). Effect of different classes of antihypertensive drugs on endothelial function and inflammation. International Journal of Molecular Sciences20(14), 3458. https://doi.org/10.3390/ijms20143458 

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