…Before investigating secondary causes, pseudo resistance must be excluded. This includes: Poor adherence to antihypertensive treatment White coat hypertension Other contributors to apparently uncontrolled blood…

… Increased risk of stroke; Increased risk of end stage renal disease; Increased mortality; and A higher probability of secondary hypertension. Patients may also have comorbid…

…the renal function and the severity of the bleeding 7 Manage antiplatelet drugs according to their indication. Do not routinely stop aspirin given as secondary…

…initiation of renal replacement therapy. The study found no significant differences between the two treatment groups with respect to either the primary or secondary outcomes…

…form of secondary hypertension. Aldosterone acts principally through the mineralocorticoid receptor (MR). After entering target cells, it binds the MR, which translocates to the nucleus…

…and can last for years. ACE Inhibitor Induced Angioedema Angioedema secondary to ACE inhibitor therapy occurs in approximately 1% of patients. It manifests as localized…

…and other bioactive compounds from nuts; and antioxidant and antithrombotic constituents from whole grains. These combined effects may improve inflammation, insulin resistance, glucose metabolism, hypertension…

…hypotension is present, or secondary arrhythmias result from the slow rate. In the setting of bradyarrhythmic or asystolic arrest, management priorities shift to establishing control…

…for an underlying secondary cause. Evaluation and physical examination Standardized office measurement Accurate technique is essential because inconsistent or incorrect measurement may lead to misclassification…

…on the provided context, the primary etiologies for axis deviations include: Causes of Right Axis Deviation: Pulmonary hypertension (primary or secondary) [9, 16] Severe pulmonary…

…international cohort evidence. Metabolic risk factors make a particularly large contribution to cardiovascular disease. Hypertension is a major component of this burden, followed by non…

…multidisciplinary secondary prevention intervention for patients with cardiovascular disease, including those recovering from myocardial infarction. It extends beyond exercise training to incorporate individualized physical activity…

…worse outcomes. Pulmonary hypertension secondary to left heart disease may occur because elevated left sided filling pressures are transmitted to the pulmonary circulation. Persistent pulmonary…

…making it more challenging to pump blood into the aorta. The most common causes are hypertension (in which the pressure in the aorta is increased…

…V2, V5 and V6), although leads aVL and I may show changes similar to those in V5 and V6. Figure 1. ECG changes in left…

…of hypotension, end organ hypoperfusion, shock states, and pulmonary congestion. In pregnant patients presenting with suspected acute heart failure, urgent hospital admission and referral to…

…prompt investigation for sleep apnoea, renal disease and secondary hypertension, and lead to one dose being moved to the evening. The fall can only be…

…lactate, acidosis, hypertension and tachycardia are common during a generalised seizure. In prolonged status the initial sympathetic response can give way to hypotension, hypoxia, hypoglycaemia…

…or secondary contributor [8] . Pathophysiology and mechanisms The pathophysiological paradigm of HFpEF has shifted dramatically from the historical concept of isolated "diastolic dysfunction" to a…

…crisis: hypotension that does not respond to fluid, abdominal pain, vomiting, fever, hyponatraemia, hyperkalaemia, hypoglycaemia. Give hydrocortisone and an isotonic crystalloid. Exact doses according to…

Cardiology Pharmacology & dosing Definition and Therapeutic Rationale Hypertension is a major risk factor for atherosclerotic cardiovascular disease and contributes to microvascular and macrovascular complications. It…

…to normal blood pressure (normotension). Combination therapy with multiple antihypertensives is often necessary to normalize blood pressure. Management of hypertension requires careful consideration of other…

…Pulmonary arterial hypertension Group 2: PH due to left heart disease Group 3: PH due to chronic lung disease, hypoxia, or sleep disordered breathing Group…

…involvement — lower it orally over days. Hypertensive emergency: raised pressure with acute organ damage (encephalopathy, pulmonary oedema, aortic dissection, acute renal failure, pre eclampsia) — intravenous…

…nitroprusside, and nicardipine in hypertensive emergencies. Time to onset of action 2 4 minutes Duration of action 5 15 minutes Delivery IV (infusion). Dose Initial…

…Edema. Dizziness. Caution Should be used cautiously in patients with myocardial ischemia and/or heart failure. Nicardipine doses and administration in hypertension (hypertensive crisis/emergency).

Calculators CHA2DS2 VASc Score Calculator Congestive Heart Failure Hypertension Age = 75 years Diabetes Mellitus Stroke/TIA/TE Vascular disease Age 65 74 years Sex…

…systemic blood pressure and increase renal perfusion. Time to onset of action 50 to 10 minutes Duration of action 30 to 60 minutes Delivery IV…

…blocks (AV blocks). Orthostatic hypotension. Paresthesias (scalp tingling). Bronchospasm. Caution • Avoided in hypertensive emergencies with left ventricular failure (due to negative inotropic effect). • Used cautiously…

…acute glomerular disease or scleroderma renal crisis [1,2]. A hypertensive emergency means a markedly raised blood pressure together with ongoing or new organ damage…

…of its administration in these patients should be carefully balanced against the potential risks resulting from hypotension. • Withdrawal of clonidine may lead to rebound hypertension…

…infusion. Adverse effects Flushing. Nausea. Bronchospasm. AV block. Caution • Avoid in acute heart failure. • May cause bradycardia. Esmolol doses and administration in hypertension and tachycardia.

…nitroprusside, and nicardipine in hypertensive emergencies. Time to onset of action 2 4 minutes Duration of action 5 15 minutes Delivery IV (infusion). Dose Initial…

…Orthostatic hypotension. Paresthesias (scalp tingling). Bronchospasm. Caution • Avoided in hypertensive emergencies with acute heart failure. • Used cautiously in patients with asthma (due to risk of…

…metabolized to cyanide. Cyanid toxicity may be fatal (should be suspected if patient develops altered mental status and lactic acidosis). Fatal outcomes are rare. Renal…

…a hypertensive emergency requiring the most rapid BP response. The objective is to reduce aortic wall shear stress and rapidly lower systolic pressure. Renal and…

…110 mmHg Headache that does not respond to medication Visual disturbance Persistent severe epigastric pain Pulmonary oedema Thrombocytopenia, with platelets <100 × 10⁹/L Renal insufficiency…

…nitroprusside, and nicardipine in hypertensive emergencies. Time to onset of action 2 4 minutes Duration of action 5 15 minutes Delivery IV (infusion). Dose Initial…

Enalaprilat Enalaprilat is rarely used in hypertensive crisis due to its slow onset, prolonged duration of effect, and significant individual variations in its effect. Drug…

…nitroglycerin regularly may have developed tolerance and require higher doses, alternatively nitroprusside to achieve desirable blood pressure lowring effect. Drug Nitroglycerin Brand names Gonitro ®…

…effects on the cardiovascular system. Acute exposure produces transient haemodynamic and myocardial effects, whereas sustained heavy consumption is associated with hypertension, coronary artery disease, arrhythmias…

…both as an independent cardiovascular risk factor and as a driver of hypertension, diabetes, dyslipidaemia and systemic inflammation. It is also associated with respiratory disorders…

…explained by coronary heart disease, hypertension, valvular disease or congenital heart disease. Cardiomyopathy leads to impaired cardiac function and heart failure. There are six main…

Echocardiography Hypertrophic cardiomyopathy (HCM): from pathophysiology to echocardiography Hypertrophic cardiomyopathy is a genetic disorder that causes left ventricular hypertrophy under normal loading conditions. Hypertrophic cardiomyopathy…

…artery into the right ventricle during diastole. The most common cause of abnormal pulmonary regurgitation is pulmonary hypertension. Table 1 presents the causes of pulmonary…

…last intake Common clinical picture : : 4 to 12 hours Tremor, sweating, anxiety, insomnia, tachycardia, hypertension, headache, nausea and vomiting 8 to 24 hours Alcoholic hallucinosis…

… higher in known hypertension Pulse pressure 40–60 mmHg A narrow pulse pressure suggests a low stroke volume Capillary refill < 3 s A simple…

…In most hypertensive emergencies the following is aimed for: 1. Lower the mean arterial pressure by no more than about 20 to 25 per cent…

…Comment : : : MAP ≥ 65 mmHg 80–85 mmHg in chronic hypertension or when there are signs of inadequate perfusion Urine output 0.5 mL/kg/h…

…puncture, and antibiotics and a corticosteroid are then given immediately after blood cultures. For questions other than acute meningitis — an insidious onset, known malignancy, immunosuppression…

…coagulopathy. Severe uncontrolled hypertension. Recent intracranial haemorrhage without a fresh assessment of benefit and risk. An inability to attend for sampling and follow up — relative…

…Definition of aortic aneurysm Sinus of Valsalva 45 mm. Any other segment 40 mm in diameter. Thresholds for surgery Threshold for surgery Relevant patient category…

…and ORBIT scores. Each incorporates various clinical parameters to stratify bleeding risk. HAS BLED: Incorporates factors such as hypertension, abnormal renal/liver function, stroke history…

…BMI and cardiovascular outcomes High BMI is associated with several health conditions: Type 2 diabetes Hypertension Coronary artery disease Heart failure Dyslipidemia (including high LDL…

…no no AQUASOL A VITAMIN A PALMITATE VITAMIN A PALMITATE NA sp ambiguous hypotension(Pediatric Use) mild BAL DIMERCAPROL Dimercaprol Mixed ar less tachycardia/blood…

…of 9. The score takes into account various risk factors that contribute to bleeding risk, including uncontrolled hypertension, impaired renal or liver function, previous stroke…

Hydralazine Hydralazine is not preferred for hypertensive emergencies due to the high risk of reflex sympathetic stimulation. Drug Hydralazine Brand names Apresoline ®, Bidil ®…

…and additionally severe hypertension (caution if patient on nonselective beta blockers). Dobutamine Cardiogenic shock Bradycardia (second line therapy) Stress testing (due to induced increase in…

Phentolamine Drug Phentolamine Brand names Oraverse ®, Rogitine ® Indications Hypertensive crisis. Mechanism of action Phentolamine is a non selective alpha adrenergic blocker. Phentolamine reduces…

…changes), renal function, and potassium should be evaluated within 1 to 2 weeks after initiation of ACE inhibitors, especially in patients with preexisting azotemia, hypotension…