Hypertension in blacks is usually characterized by low renin, expanded volume and sensitivity to salt. Diuretics are the preferred initial therapy, but response to calcium channel antagonists is also good.
What drugs are recommended as first-line therapy for hypertension in African-American patients?
Rationale: According to the JNC-8 guidelines, calcium channel blockers and diuretics are recommended as first-line therapy for management of hypertension in African-American patients. The other drugs are not recommended as first-line drugs for this group. The nurse is creating a plan of care for a patient with a new diagnosis of hypertension.
Which antihypertensive medications are most commonly used for high blood pressure?
Thiazide diuretics were the most commonly used antihypertensive medication, and persons taking a thiazide were more likely to have their BPcontrolled than persons not taking them; thiazides were used significantly less among men than women.
What are The JNC-8 guidelines for hypertension treatment in African-American patients?
Rationale: According to the JNC-8 guidelines, calcium channel blockers and diuretics are recommended as first-line therapy for management of hypertension in African-American patients. The other drugs are not recommended as first-line drugs for this group.
Are calcium channel blockers effective monotherapy for high blood pressure in African Americans?
Although calcium channel blockers are often considered to be effective monotherapy for African Americans, persons using calcium channel blocker monotherapy were significantly less likely to be at target BPthan persons using thiazide monotherapy.
What is the first drug of choice for hypertension treatment?
Generally, ACE inhibitors should remain the initial treatment of choice for hypertension. Angiotensin II receptor antagonists or angiotensin receptor blockers (ARBs) are used for patients who are unable to tolerate ACE inhibitors.
Which drug is first choice in treating hypertension for a patient of Afro Caribbean origin?
In women of black African or African-Caribbean family origin consider nifedipine or amlodipine first line. If blood pressure is not controlled with a single drug consider a combination of nifedipine (or amlodipine) and enalapril.
What is the preferred treatment for hypertension?
The two classes of medication are both recommended as "first-line" treatments for high blood pressure: angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs). ACE inhibitors have been around longer and studied more extensively, so doctors prescribe them more often.
Which drug class is recommended as first line treatment for an African American patient with hypertension quizlet?
In the text of the guideline, mentions that diuretics should be the agent of first choice for blacks with hypertension because of their proven effectiveness in clinical trials. For whites, beta-blockers are also an option for first line therapy.
Why are ACE inhibitors not first line for black people?
Angiotensin converting enzyme (ACE) inhibitors, β blockers, and angiotensin receptor antagonists are generally less effective as monotherapy in black hypertensives,22,23 because of the tendency towards a low renin state and a lower cardiac output, with increased peripheral resistance.
Are ARBs good for African American?
An ACE inhibitor or an ARB is not typically used to treat hypertension by itself for Black adults, but either can be added as a second medication. Your provider may also recommend ACE inhibitors and ARBs when you have other health conditions that affect the heart, like diabetes or heart failure.
Why are ACE inhibitors first line for hypertension?
Introduction. ACE (angiotensin-converting enzyme) inhibitors and angiotensin receptor blockers (ARBs) effectively lower blood pressure (BP) through inhibition of the renin-angiotensin system and are equally recommended as first-line medications in the treatment of hypertension.
Which ACE inhibitor is best for hypertension?
When considering factors such as increased ejection fraction, stroke volume, and decreasing mean arterial pressure, our results suggest that enalapril was the most effective ACE inhibitor.
Why are ACE-I and ARBS not recommended for African black population?
It is commonly reported that the blood pressure lowering efficacy of renin angiotensin system (RAS) inhibitors is attenuated in African Americans due to a greater likelihood of having a low renin profile. Therefore these agents are often not recommended as initial therapy in African Americans with hypertension.
Are beta blockers good for African American?
It has been reported that beta blockers are not effective antihypertensives in black populations. A review of the literature revealed that, for the most part, studies drawing this conclusion were of small sample size, lacked controls, and did not represent the demographics of the US black population.
Is metoprolol good for African American?
Our study showed that metoprolol increased SUA and risk of GRM use in African American adults. This is consistent with other clinical studies involving beta blockers.
How common is high blood pressure in Black adults?
High blood pressure is much more common in Black people as compared to other groups in the U.S. It affects 56% of Black adults in the U.S. as compared to 48% of white adults, 46% of Asian adults, and 39% of Hispanic adults.
Why is high blood pressure more common and more severe in Black people?
There’s no definitive answer for why high blood pressure is more common and more severe in Black people. Some theories have looked at genetic and environmental factors as possible causes, but it isn’t very well understood.
How is high blood pressure treated?
There are treatment plans that don’t require medication and some that do. The approach to treating high blood pressure depends on how severe it is. A healthy lifestyle can help keep hypertension in check. In fact, it’s recommended you make lifestyle modifications to help lower your blood pressure even if your provider prescribes medication for you.
Non-medication treatments for high blood pressure
For elevated blood pressure (systolic 120 to 129 mmHg and diastolic under 80 mmHg) or stage 1 hypertension (systolic 130 to 139 mmHg or diastolic 80 to 89 mmHg), non-medication management is recommended. This would include diet, exercise, and lifestyle changes.
Medication treatment options for high blood pressure
When high blood pressure persists or has advanced to stage 2 (systolic at least 140 mmHg or diastolic at least 90 mmHg), medication is recommended as additional treatment.
Is high blood pressure treated differently in Black adults?
In general, there are a few types of medications that are considered first-choices treatments for high blood pressure. These include thiazide diuretics (a type of “water pill”), ACE inhibitors, ARBs, and calcium channel blockers. For the most part, these medications are equally effective in lowering blood pressure.
Why are ACE inhibitors and ARBs sometimes not recommended for Black adults?
The simple answer is that these medications tend to not work as well in Black people. The reason for this boils down to the way ACE inhibitors and ARBs work.
What is the first line of treatment for hypertension in African Americans?
Rationale: According to the JNC-8 guidelines, calcium channel blockers and diuretics are recommended as first-line therapy for management of hypertension in African-American patients. The other drugs are not recommended as first-line drugs for this group.
Is Captopril metabolized by the liver?
C. Captopril is a prodrug and is metabolized by the liver before becoming active. D. Captopril is not a prodrug and does not need to be metabolized by the liver before becoming active. Click card to see definition 👆. Tap card to see definition 👆.
Does Captopril cause hypotensive effects?
A. Captopril rarely causes first-dose hypotensive effects. B. Captopril has little effect on electrolyte levels. C. Captopril is a prodrug and is metabolized by the liver before becoming active. D. Captopril is not a prodrug and does not need to be metabolized by the liver before becoming active.
Is Captopril a prodrug?
D. Captopril is not a prodrug and does not need to be metabolized by the liver before becoming active. Rationale: A prodrug relies on a functioning liver to be converted to its active form. Captopril is not a prodrug, and therefore it would be safer for the patient with liver dysfunction.