Angiotensin antagonists
Drugs in this group inhibit angiotensin-converting enzyme (ACE) which, in turn,
inhibits the formation of angiotensin II (vasoconstrictor) and blocks the release
of aldosterone. When aldosterone is blocked, peripheral resistance is lowered.Calcium channel blockers
These drugs dilate coronary arteries and arterioles and decrease total peripheral
vascular resistance by vasodilation.STEPPED-CARE TREATMENT
The prescribed method of treating hypertension begins with a nonpharmacolog-
ical approach such as lifestyle changes: losing weight, reducing sodium intake,
limiting alcohol intake, smoking cessation, and increasing physical activity.
If blood pressure remains elevated, then treatment moves to the next step. The
patient is administered diuretics or beta-blockers.
If blood pressure still remains high, then the dose of diuretics or beta-blockers
is increased or a calcium channel blocker, ACE inhibitor, angrotension II blocker,
or combination drug replaces or is added to the treatment plan.
If blood pressure does not decrease, the patient is given a diuretic with a beta-
blocker or a second drug is added such as a calcium channel blocker, ACE
inhibitor, alpha blocker, or centrally acting sympatholytic.
If blood pressure still does not decrease, two or three additional drugs are
administered to the patient. These include alpha blockers, direct-acting vasodila-
tors, or adrenergic neuron blockers.A list of drugs utilized in the treatment of high blood pressure is provided in
the Appendix. Detailed tables show doses, recommendations, expectations, side
effects, contraindications, and more; available on the book’s Web site (see URL
in Appendix).ANGIOTENSIN ANTAGONISTS, ACE INHIBITORS,
ANGIOTENSIN II BLOCKERSAngiotensin antagonists (angiotensin-converting enzyme inhibitors) and ACE
inhibitors inhibit the formation of angiotensin II (vasoconstrictor) and block the
release of aldosterone. Aldosterone promotes sodium retention and potassium(^358) CHAPTER 19 Cardiac Circulatory Medications