Pathophysiology and Pharmacology of Hypertension Disorder

The cardiovascular disorder under consideration is hypertension. This disorder is associated with a sustained increase of inactive systolic blood pressure, BP or diastolic BP or all of them inclusive. Hypertension disorder can be either of a known cause, essential hypertension, or known cause, secondary hypertension. The disorder has been attributed to be the primary cause of mortality and morbidity due to its involvement with renal disease, coronary heart condition, and cerebrovascular disease. Therefore, it is significant to explore the pathophysiology of the disorder, the impact of genetic factors on its pathophysiology and maladaptive responses, and the drugs used to treat it and their side effects.

Pathophysiology and maladaptive responses of hypertension disorder

Several interrelated factors have been ascribed to contribute to an unremitting elevation of BP. The long-standing consequences of increased blood pressure are involved with end-organ damage, which upshots into increased morbidity and mortality.  BP is termed as a product of total vascular resistance and cardiac output. Therefore, individuals suffering from hypertension experience either an increased cardiac output or increased systemic vascular resistance, or their combination (McCance & Huether, 2019). Generally, elevated systemic vascular resistance, high vascular stiffness, and elevated vascular sensitivity to stimuli are the principal constituent of hypertension pathophysiology. On the other side, the maladaptive and physiological responses of hypertension have been linked with amplified sensitivity to stressful stimuli. Research depicts that deliberate and frequent thoughts about negative events can increase blood pressure, intensify, and prolong cortisol reactions (Bickley, 2017). This is a result of a stress response, which is exemplified in part by reductions in cardiac output and elevations in systemic peripheral resistance..

Effects of genetics on the pathophysiology of Hypertension disorder

Multiple genes have been attributed to contributing to the progression of hypertension disorder in a particular person. Studies depict that individuals who have one or two hypertensive parents have a high likelihood of suffering from hypertension. Also, several epidemiological researchers propose that genetic factors account for about 30% of the deviation in blood pressure in different populations. Some family concordance has been linked to a parted lifestyle, primarily dietetic factors (Bickley, 2017). For instance, some researchers have associated the α-Adducin gene with salt-sensitive hypertension. Also, the angiotensin-converting enzyme gene has been correlated to hypertensive nephropathy or left ventricular hypertrophy.

Required drugs

Drugs to be prescribed for hypertension patients differ depending on the blood pressure and the existence of the atherosclerotic cardiovascular disease. The most preferred drugs include all anti-hypersensitive drugs whose working mechanism intends to decrease the cardiac output and peripheral vascular resistance. For instance, a low dose of diuretics drugs is effective in the reduction of other disorders associated with hypertension, including stroke, congestive heart failure, total mortality, and coronary heart disease (Arcangelo et al., 2017). Beta-blockers are also used to help in managing heart failure condition, which has been identified as an underlying complication for patients with arterial hypertension. They are introduced at small doses to minimize a preliminary deterioration of heart malfunction. Besides, angiotensin-converting enzyme, ACE inhibitors are recommended (Arcangelo et al., 2017).  Their mechanisms exert a shielding effect other than reducing BP. They generally slow down the development of heart failure and renal dysfunction.

Effects of the prescribed drugs

The most common side effect associated with ACE include is a continuous dry cough, headaches, a rash, and dizziness. On the other hand, diuretics have been linked with side effects such as dizziness when one is standing up, elevated thirst, an urge to visit the toilet more frequently, and redness on the skin (Bickley, 2017). Moreover, β-blockers are associated with emergence symptoms such as sexual dysfunction, depression, and fatigue.

References

Arcangelo, V., Peterson, A., Wilbur, V., & Reinhold, J. (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Philadelphia, PA: Wolters Kluwer.

American College of Cardiology. (2017). New ACC/AHA high blood pressure guidelines lower definition of hypertension. Retrieved from https://www.acc.org/latest-in-cardiology/articles/2017/11/08/11/47/mon-5pm-bp-guideline-aha-2017

Bickley, L. S. (2017). Bates guide to physical examination and history taking (12th ed.). Philadelphia, PA: Wolters Kluwer.

McCance, K., & Huether, S. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Elsevier/Mosby.