Managements of Cardiac Diseases

Management of Hypertension
1. Risk factors: smoking, hyperlipidemia, diabetes mellitus, >60 year of age, gender (men & postmenopausal women), family history of premature
cardiovascular disease, obesity, obstructive sleep apnea, microalbuminuria
Life style modification
- Smoking cessation
- Weight reduction
- Moderation of alcohol consumption'
- Reduce salt intake
- Maintain adequate intake of potassium, magnesium & calcium
- Increase physical activity
- Reduction of cholesterol and saturated fat intake

Effective antihypertensive combinations
- Diuretic and beta blocker
- Diuretic and ACE inhibitor or angiotensin II receptor antagonists
- Diuretic and calcium antagonists
- Calcium antagonists and beta blocker
- Calcium antagonists and ACE inhibitor
- alpha blocker and beta blocker

Management of Hypertension in Pregnancy
Gestational Hypertension: Hypertension diagnosed for the first time after mod pregnancy w/o proteinuria
without symptoms and with normal laboratory test results.
- Women who have stage 1-2 essential hypertension with normal renal function may be treated with non drug therapy under close observation
- Treatment does not decrease the chance of developing pre-eclampsia
- Women who are well controlled may stay on their antihypertensive therapy except if it is an ACE inhibitor or an angiotensin II receptor antagonists
Recomended therapy: methyldopa is preferred agent
Alternatives: Labetalol
other antihypertensive agents may cause interaction effects with the foetus.

Note: all dosage recomendations are for non-elderly adults with normal renal & hepatic function unless otherwise stated.
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So here all the matters which will coming up next week. wish me luck to get good score..