Essential Hypertension and Calcium Channel Blockers

Abstract

Human health is essential in all avenues of life. This article presents an in-depth discussion of hypertension in terms of physiology, pathophysiology, and pharmacology, as well as the critical roles of calcium-channel blockers. Several actions are undergoing within the human system that leads to hypertension, where the arteries and the heart are the key avenues of the actions. Pathophysiology plays an important role in the deification of the origin of the disorder. This aids in a clear understanding of the leading causes of hypertension within the human body. They include endothelial dysfunction, cardiac output, autonomous nervous system, and hypercoagulability. The essay further expounded on the pharmacology treatment to be explored for effective treatment of the diseases. The drugs were presented in terms of class and name, routes of administration, mechanism of action, pharmacokinetics, precautions, and side effects. Additionally, the essay illustrates some of the crucial aspects that patients and the general public should explore when dealing with hypertension issues. These were based on using natural products, resistance to certain products, and adopting a new lifestyle to keep the blood pressure at an acceptable level. Finally, the essay addressed the relevance of hypertension and pharmacology within the clinical sector. From the essay, we can perceive that hypertension and pharmacology are much relevant to each other from drugs and disease. Pharmacology aids in practically evaluating which drug to be prescribed to treat or address hypertension. Therefore, Pharmacology and hypertension are relevant in the clinical sector because they provide an avenue to exercise their expertise and skills in offering appropriate drugs to address specific disorders.     

 Introduction

            Increased vascular stiffness, systematic resistance, and responsiveness to change are critical in hypertension’s pathophysiologies. Calcium antagonists depend on various ways of action in hypertension. According to Gupta and Schallek (2020), Calcium channel blockers (CCBs) are perceived to lower blood pressure preventing calcium from reaching the heart and arteries cells.

The blocking mechanism reduces all mechanical operations of vascular muscle leading to vasodilation. Another blocking action is on norepinephrine which is mediated vasoconstriction. This occurs due to vasoconstriction of the sympathetic alpha produced by calcium influx into the cell; thereby, a decrease in calcium influx will correspond to a decrease in norepinephrine vasoconstriction. Intracellular calcium also regulates the release of renin by the kidney cells because calcium antagonist suppresses renin release and the renin-angiotensin system. Calcium-channel blockers are critical in hypertensive patients having spastic and stable angina. CCBs vasodilation property enhances after-load reduction and relaxant properties of its regional smooth muscles that are critical in alleviating coronary spasms.       

Pathophysiology

There is little uncertainty about the pathophysiology of hypertension. Few underlying adrenal and renal diseases have been perceived as the major causes of high blood pressure (Safdar, 2020, 4030). On the other hand, a specific cause of the disease has not been identified though their conditions have been labeled as essential hypertension.

However, several physiological mechanisms have been involved in developing and maintaining normal blood pressure, and their derangement causes essential hypertension. The following are the significant contributors to essential hypertension.

  • Endothelial Dysfunction: Vascular endothelial cells contribute to cardiovascular regulations by producing several local vasoactive agents and vasoconstrictor peptides. Endothelium dysfunction is associated with essential hypertension because endothelial functions have been perceived as an essential therapeutic attempt to minimize hypertension complications (Sun, 202, 1563). From the clinical perspective, practical antihypertensive therapy seems to restore the diminishing nitric oxide production though it does not restore the disabled endothelium vascular response. This shows that endothelial dysfunction is primary and can only be irreversible upon the establishment of hypertension.
  • Cardiac output and peripheral resistance: At the early stages of hypertension, peripheral resistance is not high, and blood pressure elevation is caused by increased cardiac output, which is compared to sympathetic overactivity (Limberg et al., 2010, 165) Continuous resistance in peripheral arteriolar may develop into a compensatory manner to deter the raised pressure from being supplied to the capillary bed to initiate cell homeostasis.
  • Autonomic nervous system: Stimulation of the nervous system can cause constriction and dilation of the arteriolar, where the autonomic nervous system is essential in maintaining normal blood pressure. Drugs that block the sympathetic nervous system Lowers blood pressure with an established therapeutic responsibility (Robles-Vera, Toral and Duarte, 2020, 890). Therefore, hypertension is probably an interaction between renin-angiotensin and the autonomic nervous system with other factors such as circulating volume, sodium, and other hormones.
  •  Hypercoagulability: Hypertension can be demonstrated through vessel wall abnormalities, blood constituents, and blood flow, which indicates that hypertension gives a hypercoagulable or prothrombic state (Winters, 2021). These elements are related to prolonged prognosis and organ damage, which may be altered through antihypertensive treatment.

Pharmacology

Pharmacology deals with drug effects on the biological system and how the body responds to the drug (Stoppler, 2021). This section will expound on possible drugs that can be administered to address essential hypertension disorders. They are discussed below.

  • It is classified under Cardizem. The drug is in the form of tablets consumed through oral administration. The dosage is prescribed into 30 and 90 mg taken three to four times a day. The gastrointestinal tract absorbs the drug in less than fifteen minutes in an onset action, thirty minutes during peak effect, and a half-life of about four hours (Landry et al., 2021, 155). The drug’s most frequent side effects include; dry mouth, AV block, rash, headache, vertigo, and edema. Diltiazem SR is a monotherapy used in the initial management of a less complicated hypertension situation through oral administration of conventional tablets taking three to four doses per day at bedtime and before meals. Children and older people are expected to consume lower dosages.
  • This drug falls under the Procardia class and is used to address essential hypertension. The dosage is taken thrice daily and ranges from 10 to 20 mg. The dosage is consumed through oral administration, absorbed along the gastrointestinal tract, and metabolized in the liver (Bi, Jia, and Wang, 2020, 206). Additionally, the dosage is highly restrained to plasma proteins with an approximate half-life of two hours. The most common side effects of the dosage include peripheral edema, headache, SA node stimulation, and reflex tachycardias. Short oral dihydropyridine should not be used for hypertension due to risky myocardial infractions. Oral Nifedipine is used in the treatment of severe hypertension during an emergency. It is recommended that doses beyond 100 mg should not the consumed.  
  • Verapamil Hydrochloride. This dosage falls under Calan and Isoptin. The dose is administered orally with a prescription of 240 to 640 mg daily to aid in essential hypertension control. Verapamil is completely absorbed along the gastrointestinal tract with an intense hepatic effect on the first pass. The dosage administration is associated with the following side effects; headache, constipation, peripheral edema, heart blocks, flushing, and AV nodal. Verapamil uses antihypertensive results to reduce systematic vascular resistance without orthostatic blood pressure reduction (Aronow, 2020, 2). The dosage also reduces arterial pressure at a static level by reducing peripheral resistance. The dosage should be titrated before use by all individuals.

Important Aspects Patients should consider regarding hypertension

            Considering the medical drugs that can be used to address hypertension, other potential medications effectively manage hypertension. These can be in the form of natural products, lifestyle, and even other effective medications. Below are some of the ways an individual considers when dealing with hypertension.

  • Undertaking exercise. Exercising for about thirty to sixty minutes is paramount to achieving healthy living. This will help lower blood pressure and improve strength, mood, and balance.
  • Reduction of a saltshaker. Minimum consumption of sodium is essential in lowering blood pressure. On the other hand, high sodium intake makes your body retain more fluids, leading to increased blood pressure (Kim, 2021, 15). Instead of consuming high sodium content, one can use spices and herbs to add more flavor to taste.
  • Adopt a DASH diet. The DASH diet is an effective strategy that aids in lowering blood pressure. DASH diet means Dietary Approaches to Stop Hypertension (Said et al., 2021). It consists of consuming vegetables, fruits, and whole grains, eliminating highly saturated foods such as fatty meats, and low dairy products consumption such as nuts.
  • Limit alcohol. Moderation consumption of alcohol is good for heart health. However, excessive consumption of alcohol is dangerous since it contributes to high blood pressure. Men are advised to take two drinks per day, and women are limited to one alcoholic drink every day.
  • Medication Adherence. Long-term management is very crucial when medication is implemented. Lack of medication adherence may lead to failure to attain blood pressure control.

Relevance of hypertension and Pharmacology

The relevance between hypertension and pharmacology, especially in nursing, is how the drugs are channeled to address the disorder. To address hypertension, clinicians must dig deep into pharmacology to find the appropriate drug to administer. For example, patients with essential hypertension will be treated with drugs to reduce system vascular, blood volume and reduction of cardiac output to depress stroke volume and heart rate. This indicates that pharmacology is more relevant to hypertension in the clinical sector. Pharmacology helps nurses and clinicians learn more about drugs regarding administration mode, brand names, precautions, side effects, and pharmacokinetics factors essential when handling drugs.  

Conclusion  

            Hypertension treatment can be done through many drugs with different avenues of action to treat the disease effectively. Even though antihypertensive drugs have some benefits, they may be exposed to specific clinical side effects like orthostatic hypotension. Therefore, to effectively provide high-quality care, medical providers should understand how antihypertensive medications affect the rehabilitation session.

References

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