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Hypertension (Risk factors (Male sex, Ethnicity (African-Carribbean,…

- - - - ARBs
        Indication: ACE-I not tolerated
        E.g. candesartan, losartan
        MOA: inhibit AngII action at Ang II-R; less effective in low renin states
        SEs: vertigo, rash, itch, renal failure
      - B-blockers
        Indication: ACEI/ARB CI or not tolerated; add on therapy
        E.g. bisoprolol
        MOA: dampen SNS activity, causing vasodilatation
        SE: bronchospasm, HF, bradycardia, fatigue
        CI: asthma
      - Diuretics
        Indication: add-on therapy, thiazides then loop
        E.g. bendrflumethiazide, furosemide
        MOA: incnrease Na excretion thus water excretion,
        reducing preload and BP
        SEs: hypo-Na, hypo-K, gout, ED
        CI: gout
      - ACE-I
        Indication: 1L <55y non-Black, stage 1 end organ damage or stage 2/3
        E.g. ramipril, lisinopril
        MOA: inhibit AngI to Ang II, causing vasodilatation;
        less effective in low renin states (older, Black, Conn's, T2DM
        SEs: cough, first dose hypotension, hyper-K,
        rashes, renal failure, angioedema
        CI: bilateral RAS, pregnancy, AS
      - CCBs
        Indication: 1L >55y or Black, stage 1 end organ damage or stage 2/3
        E.g. amlodipine, nifedipine, diltiazem, verapamil
        MOA: peripheral dilatation, some reduce cardiac contractility
        SEs: ankle oedema, hot flushes, gum hyperplasia, bradycardia, headaches, fatigue, constipation
        CI: HF (cardioselective types e.g. diltiazem, verapamil)
      - A-blockers
        Indication: add-on therapy
        E.g. doxazocin
        MOA: inhibit SNS activity, vasodilatation
        SEs: dizziness, urinary incontinence
      - Renin inhibitors
        Indication: add on (rarely used)
        E.g. aliskerin
        MOA: inhibit renin, less effective in low renin state
        SE: hyper-K, diarrhoea, rash
        CI: CRF, current ACI/ARB use (same MOA)
      - Centrally-acting agents
        Indication: add on therapy; pregnancy
        E.g. methyldopa, clonidine, moxonidine
        SEs: sedation, depression
      - Vasodilators
        Indication: add on
        E.g. hydralazine
        MOA: directly act on vasculature to cause vasodilatation
        SEs: flushing, ankle swelling, hirsuitism
    - - Lipid-lowering
        agents
        
        Statins
        Indication: 1L if >20% CVD risk;
        hyperlipidemia; post-MI/stroke/TIA
        E.g. atorvastatin, simvastatin
        MOA: HMG-CoA reductaase inhibitor, reducing cholesterol
        synthesis in the liver
        SEs: myalgia, myositis, deranged LFTs, abdominal pain
        CI: pregnancy, acute liver idsease, cholestasis
        
        Fibrates
        Indication: 2L if statin CI/not tolerated
        E.g. benzafibrate, ezetimibe
        SEs: flushing
      - Aspirin
        Indication: >55y
        MOA: reduces risk of thrombus formation
        by inhibiting platelet aggregation
        SE: GI bleeding