Diagnosis and management of hypertension in primary care

Abstract

Hypertension is a major modifiable risk factor for cardiovascular disease, but conflicting opinions remain about optimal blood pressure targets. This article discusses the various definitions of hypertension, provides guidance on management in primary care and advises when referral to secondary care is needed.

Beta-Arrestins in the Treatment of Heart Failure Related to Hypertension: A Comprehensive Review

“…Independent β-arrestin signaling of G-proteins is also induced by this [9,28,29]. This SIIstimulated signaling affirms that the conformations of the β-arrestin coupling receptor and the G-protein-activating receptor are distinct [8]. In contrast, β-arrestin's effects in isolated adult mouse cardiomyocytes suggested that, in isolated cardiac myocytes, the contraction of β-arrestin signaling is induced via SII, indicating the cardiac role of βarrestin-biased ligands [30].…”

“…Non-renin enzymes like cathepsin and tonin also interact with angiotensinogen directly to produce Ang II. Ang II is further affected by proteolytic cleavages that produce angiotensin III (Ang III) or Ang-(2-8) and angiotensin IV (Ang IV) or Ang (3)(4)(5)(6)(7)(8).…”

“…The elevated volume and enlargement of the heart as a result of hypertension eventually lead to cardiac failure. The exact cause of hypertension is not discernable at all; however, different primary and secondary causes, such as genetic factors, fibromuscular dysplasia, primary aldosteronism, alcohol consumption, and the usage of over-the-counter (OTC) medications, are accountable for this clinical syndrome [8].…”

“…. Renin cleaves angiotensinogen to form angiotensin-I (Ang I) or Ang-(1-10), an inert decapeptide that is hydrolyzed by angiotensin-converting enzyme (ACE) to produce the octapeptide angiotensin II (Ang II) or Ang-(1)(2)(3)(4)(5)(6)(7)(8). Many enzymes like serine protease chymase have the same strength as ACE, where the activity of the chymase is not affected by ACE.…”

An Overview on the Role of Family Physicians in Diagnosis and Management of Hypertension

“…To identify such members in the family with the condition, the physician may request for family history of hypertension. From the history that the family gives if either of the parents or both; uncle or aunt has hypertension that without a doubt raises suspicion for greater risk [12]. Apart from digging into the family history and possible hypertension, the physician can also consider the family's sleeping habits.…”