浙江大学：《药理学 Pharmacology》课程教学资源（PPT讲稿）抗高血压药 Antihypertensive Drugs

Antihypertensive Drugs

When blood presses 12 PIosson recordng Cut pressure Blood pressure Hypertension: i ol The most common disease causing various complications

Antihypertensive Drugs Overview Classification of antihypertensive drugs Antihypertensive drugs Rational application of antihypertensive drugs

A. Overview Hypertension essential hypertension-90% secondary hypertension% Criterion of hypertension: diastolic blood pressure >90 mmHg systolic blood pressure >140 mmHg

A. Overview Major factors influencing blood pressure Arterial blood Cardiac Peripheral arteriolar ≈ pressure」 output resistance tone Blood youme Heart Contractility Filling rate pressure Venous tone Baroreceptors and sympathetic nervous system Renin-angiotention-aldosterol system(RAAS)

2. Capacitance Venules 3. Pump output Heart CNS- Sympathetic nerves 4. Volume 1. Resistance Kidneys Arterioles Renin Aldosterone Angiotensin Regulation of blood pressure (neural endocrine pathways)

Vasomotor center Methyldopa Guanabenz Sympathetic nerve terminals Guanethidine guanadrel Sympathetic Regulation of blood pressure: Sympathetic ganglia B-Receptors of heart Trimethaphan Propranolol and other B-blocke Targets of antihypertensive Angiotensin a-Receptors of vessels Vascular smooth muscle receptors of vessels Prazosin and Hydralazine Verapamil and other Losartan and other a, blockers calcium channel rugs other angiotensin Nitroprusside blockers receptor blockers B-Receptors of juxtaglomerular cells that release renin Thiazides, etc Propranolol and Endocrine/body fluid converting enzyme Angiotensin‖l Renin sInogen Captopril and other ACE inhibitors

Arenas Arterioles From ve c Vasoconstriction o arteriole (increased cont acton of eircular smooth muscle in the artena Heart contracting and emptying wall, whch leads to aused by: increased resistance I Myogenic actvily Oxygen (o) Carbon doxide(CoJ and other metabolite I Sympathetic ssmutason Vasopresin, a^ lotensin目 Arteries Vasodilation T下FFF Arenales of cicuta smooth musee in te arter oar wa, which leads to Caused by: tt_t decreased resistance and ncreased now I cO, and other medabots 4 Sympathetic stimulation Heart relaxing and filling Peripheral resistance and vascular tone and elasticity

Collagenic smoot msoe Normal blood cap of plaque Lpd.ch core Endowel Arterial wall hypertrophy and sclerosis

B Classification of Antihypertensive Drugs Diuretics Sympathetic nervous system inhibitors mainly, adrenoceptor antagonists Calcium channel blockers Regin-angiotensin system inhibitors Others Central antihypertensive drugs Vasodilators