第22章 抗高血压药英文PPT课件
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抗高血压药-英文版PPT
Second, humoral regulation:
renin – angiotensin aldosterone system
-R blockers
Kidney adjacent
renin
invertase
Beside tbhaelml achineAngiotensin original
angiotensinⅠ angiotensin Ⅱ
ACEI
Small artery contraction losartan
Aldosterone secretion Water sodium retention diuretic (thiazides)
Classification
Diuretic The sympathetic nervous depressants (1) central blood pressure medication (2) the ganglion block (3) noradrenaline can nerve endings block (4) the adrenaline receptor blockers Affect the renin - angiotensin system medicine
antihypertensive effect is mild, persistent, long-term application of no significant resistance
Features:
Antihypertensive effect is weak, by an average of 10% 2 ~ 3 weeks after the majority of patients in medical work Can be used for various high blood pressure (basic blood pressure medication) Mild - alone, medium and severe - share Can make the elderly hypertension patients complicated with stroke, the incidence
第22章 抗高血压药英文
RENIN-ANGIOTENSIN SYSTEM (RAS)
ANGIOTENSINOGEN RENIN ANGIOTENSIN I KININOGENS KALLIKREINS BRADYKININ
ANG II blocker
ANGIOTENSIN II
ACE
ACE inhibitor
INACTIVE METABOLITES
Adrenoceptors
Sodium Retension Angiotensinogen
Vasodilator Peripheral Resistance
-blocker Cardiac Output BP BP Renin
Angiotensin I ACE inhibitors Angiotensin II ANG II blocker Renal blood flow
Therefore, it is important to treat hypertension and reduce mortality and morbidity of these conditions
Complications of untreated hypertension
• Hypertensive cardiovascular disease • Hypertensive cerebrovascular disease and dementia • Hypertensive renal disease • Aortic dissection • Atherosclerotic complication
Diagnosis of Hypertension
• is based on repeated, reproducible measurements of elevated blood pressure. • BP 140/90 mm Hg
抗高血压药-课件英文版.ppt
Reduce the complicati ons such as brain, heart and kidney
Reduce the mortality rate, prolong life
Blood pressure
- The factors influencing blood pressure ：
The postsynapti
c membrane
receptor
Vascular smooth muscle
clonidine mecamylamine
-methyldopa
Reserpine
Eplerenone
guanethidine
hydralazine propranolol sodium nitroprusside 1 prazosin nifedipine 1 labetalol minoxidil
Antihypertensive drugs
Reasonable application of antihypertensive drugs
Control of blood pressure
Delay the formation and developmen t of atherosclero sis
A gleam of antihypertensives: diuretic, calcium antagonist medicine, beta receptor blockers and ACEI
Diuretic
On the basis of (a line) blood pressure medication Effect in the thiazide diuretic is most commonly used,
抗高血压药_课件英文版
Second, humoral regulation: renin – angiotensin aldosterone system
-R blockers
Kidney adjacent
renin
invemachine
Angiotensin original
Antihypertensive drugs
hypertension
Mean arterial blood pressure is higher than the normal range, in the case of not taking blood pressure drugs ： Systolic blood pressure ≥18.7kPa(140mmHg)and（or） Diastolic blood pressure ≥12.0kPa(90mmHg)
Antihypertensive drugs
Reasonable application of antihypertensive drugs
Control of blood pressure
Delay the formation and developme nt of atheroscle rosis
incidence of left heart failure and mortality is left
Hydrochlorothiazide
Early antihypertensive mechanism
effect is mild, persistent, long-term application of no significant resistance
Features:
Antihypertensive effect is weak, by an average of 10% 2 ~ 3 weeks after the majority of patients in medical work Can be used for various high blood pressure (basic blood pressure medication) Mild - alone, medium and severe - share Can make the elderly hypertension patients complicated with stroke, the
抗高血压药_完整英文版ppt课件
A gleam of antihypertensives: diuretic, calcium antagonist medicine, beta receptor blockers and ACEI
Diuretic
On the basis of (a line) blood pressure medication Effect in the thiazide diuretic is most commonly used,
Cardiac output :heart rate, myocardial contraction force, change of blood volume, etc.;
Peripheral resistance: the length of the blood vessels and blood viscosity, blood vessels, radius, etc.
Second, humoral regulation:
renin – angiotensin aldosterone system
-R blockers
Kidney adjacent
renin
invertase
Beside tbhaelml achineAngiotensin original
angiotensinⅠ angiotensin Ⅱ
Antihypertensive drugs
hypertension
Mean arterial blood pressure is higher than the normal range, in the case of not taking blood pressure drugs ： Systolic blood pressure ≥18.7kPa(140mmHg)and（or） Diastolic blood pressure ≥12.0kPa(90mmHg)
Diuretic
On the basis of (a line) blood pressure medication Effect in the thiazide diuretic is most commonly used,
Cardiac output :heart rate, myocardial contraction force, change of blood volume, etc.;
Peripheral resistance: the length of the blood vessels and blood viscosity, blood vessels, radius, etc.
Second, humoral regulation:
renin – angiotensin aldosterone system
-R blockers
Kidney adjacent
renin
invertase
Beside tbhaelml achineAngiotensin original
angiotensinⅠ angiotensin Ⅱ
Antihypertensive drugs
hypertension
Mean arterial blood pressure is higher than the normal range, in the case of not taking blood pressure drugs ： Systolic blood pressure ≥18.7kPa(140mmHg)and（or） Diastolic blood pressure ≥12.0kPa(90mmHg)
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ACEI: angiotensin-converting Enzyme inhibitor A II ant: angiotensin II receptor antagonist
-blocker BP
ACEI AII ant.
Ca-Blocker
Alternative Medicine
RENIN-ANGIOTENSIN SYSTEM (RAS)
Antihypertensive Agents
Zhu Yi Zhun, Dept. of Pharmacology, SPFDU Email:
Hypertension
• Incidence: 10-20% in adults
e.g. 5 millions Americans have hypertension.
Diagnosis of Hypertension
• is based on repeated, reproducible measurements of elevated blood pressure.
• BP 140/90 mm Hg
Management of Hypertension
Antihypertensive Therapy
ACE: Angiotensin Converting Enzyme
ACE INHIBITOR
Originally found in snake venom The synthesized inhibitors are competitive inhibitor tightly bound to the Zn2+ ions of the ACE preventing the access of the ACE substrates to the active site of ACE Inhibit Angiotensin II synthesis Inhibit Bradykinin degradation Captopril was the 1st ACE inhibitor introduced to the market. Ramipril, Enalapril, Moexipril, Lisinopril etc. have been synthesized thereafter.
Classification of Hypertension
-- Primary (Essential) Hypertension (PH): About 90%-95%. Onset 25-55 years. No cause can be established for 95% cases of PH.
Classification of Blood Pressure
Systolic Blood Diastolic Blood
Pressure (mm Hg) Pressure (mm Hg)
Normal
< 130
<85
High Normal
130-139
85-90
Hypertension
Stage 1 (mild)
Vasodilator
-blocker
Angiotensinogen
Peripheral Resistance
Cardiac Output
Renin Angiotensin I
ACE inhibitors
ANG II blocker
Angiotensin II
BBPP
al blood
flow
Angiotensin II Renal blood
flow
Regulation of Blood Pressure
Brain Stem
Sympatholytic drugs
Sympathetic Stimulation
Aldosterone Diuretics
Adrenoceptors
Sodium Retension
Complications of untreated hypertension
• Hypertensive cardiovascular disease • Hypertensive cerebrovascular disease and dementia • Hypertensive renal disease • Aortic dissection • Atherosclerotic complication
-- Secondary Hypertension (SH): About 5%-10%. Cause: Renal disease Hormonal (e.g. Estrogen) therapy Renal vascular hypertension Hypertension associated with pregnancy Hypercalcemia, hyper- or hypothyroidism etc.
140-159
90-99
Stage 2 (moderate)
160-179
100-109
Stage 3 (severe)
>180
>110
BP= CO x PVR
CO: Cardiac Output;
PVR: Peripheral Vascular Resistance.
Regulation of Blood Pressure
Brain Stem
BP= CO x PVR
Sympathetic Stimulation
Aldosterone
Adrenoceptors
Sodium Retension
Peripheral Resistance
Cardiac Output
BP
Angiotensinogen
Renin Angiotensin I
68% are aware of their diagnosis. 53% are receiving treatment. Only 27% are under control of the 140/90 mm Hg threshold.
Hypertension
• is usually asymptomatic
• is associated with increased risk from ischemic heart disease, cerebrovascular accidents, heart and renal failure.
End organ damage
Therefore, it is important to treat hypertension and reduce mortality and morbidity of these conditions
ANGIOTENSINOGEN
KININOGENS
RENIN
KALLIKREINS
ANGIOTENSIN I
ANG II blocker
ANGIOTENSIN II
ACE
BRADYKININ
INACTIVE
ACE inhibitor METABOLITES
AT 1 RECEPTOR
AT 2 RECEPTOR
-blocker BP
ACEI AII ant.
Ca-Blocker
Alternative Medicine
RENIN-ANGIOTENSIN SYSTEM (RAS)
Antihypertensive Agents
Zhu Yi Zhun, Dept. of Pharmacology, SPFDU Email:
Hypertension
• Incidence: 10-20% in adults
e.g. 5 millions Americans have hypertension.
Diagnosis of Hypertension
• is based on repeated, reproducible measurements of elevated blood pressure.
• BP 140/90 mm Hg
Management of Hypertension
Antihypertensive Therapy
ACE: Angiotensin Converting Enzyme
ACE INHIBITOR
Originally found in snake venom The synthesized inhibitors are competitive inhibitor tightly bound to the Zn2+ ions of the ACE preventing the access of the ACE substrates to the active site of ACE Inhibit Angiotensin II synthesis Inhibit Bradykinin degradation Captopril was the 1st ACE inhibitor introduced to the market. Ramipril, Enalapril, Moexipril, Lisinopril etc. have been synthesized thereafter.
Classification of Hypertension
-- Primary (Essential) Hypertension (PH): About 90%-95%. Onset 25-55 years. No cause can be established for 95% cases of PH.
Classification of Blood Pressure
Systolic Blood Diastolic Blood
Pressure (mm Hg) Pressure (mm Hg)
Normal
< 130
<85
High Normal
130-139
85-90
Hypertension
Stage 1 (mild)
Vasodilator
-blocker
Angiotensinogen
Peripheral Resistance
Cardiac Output
Renin Angiotensin I
ACE inhibitors
ANG II blocker
Angiotensin II
BBPP
al blood
flow
Angiotensin II Renal blood
flow
Regulation of Blood Pressure
Brain Stem
Sympatholytic drugs
Sympathetic Stimulation
Aldosterone Diuretics
Adrenoceptors
Sodium Retension
Complications of untreated hypertension
• Hypertensive cardiovascular disease • Hypertensive cerebrovascular disease and dementia • Hypertensive renal disease • Aortic dissection • Atherosclerotic complication
-- Secondary Hypertension (SH): About 5%-10%. Cause: Renal disease Hormonal (e.g. Estrogen) therapy Renal vascular hypertension Hypertension associated with pregnancy Hypercalcemia, hyper- or hypothyroidism etc.
140-159
90-99
Stage 2 (moderate)
160-179
100-109
Stage 3 (severe)
>180
>110
BP= CO x PVR
CO: Cardiac Output;
PVR: Peripheral Vascular Resistance.
Regulation of Blood Pressure
Brain Stem
BP= CO x PVR
Sympathetic Stimulation
Aldosterone
Adrenoceptors
Sodium Retension
Peripheral Resistance
Cardiac Output
BP
Angiotensinogen
Renin Angiotensin I
68% are aware of their diagnosis. 53% are receiving treatment. Only 27% are under control of the 140/90 mm Hg threshold.
Hypertension
• is usually asymptomatic
• is associated with increased risk from ischemic heart disease, cerebrovascular accidents, heart and renal failure.
End organ damage
Therefore, it is important to treat hypertension and reduce mortality and morbidity of these conditions
ANGIOTENSINOGEN
KININOGENS
RENIN
KALLIKREINS
ANGIOTENSIN I
ANG II blocker
ANGIOTENSIN II
ACE
BRADYKININ
INACTIVE
ACE inhibitor METABOLITES
AT 1 RECEPTOR
AT 2 RECEPTOR