HYPERTENSION

= x

140 mmHg
90 mmHg

(essential HTN 95%)

(secondary HTN 5 %)

30%
, ,

- , ,

- , , , ,
, , ,

1) : 2
2) : 1
3) 1 : 1-2
4) 2
- 180/110mmHg ,
1
- 1

Effects of Hypertension

1. , , ,

2.
3. ,
(occipital pain), ,
4.

5.
6. ,

20/10 mmHg

- , , ,

30 ~ 45%

20 ~ 25%

50%

Intubation

CVA risk

Desflurane Heartrate, BP

(140/90mmHg)
( , 130/80mmHg
)

(SBP140~159
or

(SBP<160 or

DBP90~99mmH
g)

<100mmHg)

Thiazide
*

DBP

***

2
**

* : ACE , ARB,
BB, CCB,

** : thiazide
+ACE , ARB, BB,
CCB

*** :

, , ,

, ,

Thiazide

Hydrochlrothazide

Loop

Furosemide, ethacrynic acid, torsemide

K+

Triamterene, spironolactone, amiloride

Methyldopa, clonidine, guanabenz

Metoprolol, atenolol, propranolol

Prazocin, phentolamine

Labetalol

Neuron blocker

Reserpine, guanethidine

Captopril, enalapril

Angiotensin II

Losartan

Verapamil, diltiazem, nifedipine, amlodipine

- ,

(fixed-dose combitab)
-

Thiazide +

+ ACE

+ Ca2+

+ verapamil

Thiazide
Loop
K+

Na+,

, , , ,

Hydrochlorothiazide (Dichlorozid)

- 1 12.5 mg 25 mg
- Creatinine > 1.4 .
- ; , , , ,

Furosemide (Lasix)

- loop diuretics,
- 20-80mg qd ( 600mg/day)

Spironolactone (Aldactone)

- Aldosterone antagonist
- 1 25 mg ~ 50 mg
- (cardiac remodeling
)
-

-methyldopa, clonidine, guanabenz

2-adrenaline

, , ,

1 adrenaline

adrenaline

Prazocin, doxazosin, terazocin

1
,

, , , , ,

-adrenaline

-adrenaline

, renin ,

Metoprolol, acebutolol, atenolol

, -
Propranolol

, , , ,

-adrenaline

Atenolol (Tenormin ), Celiprolol (Selectol )

1 25 mg 50 mg qd
Selectol 200-400mg

: , ,
2 3

Angiotensin II


Aldosterone
1

: 5-20%


captopril ( ): 25 mg bid-tid
enalapril ( ): 10-40 mg/day 1-2
lisinopril ( ): 20-40mg qd
fosinopril ( ): 20mg qd

ANGIOTENSIN II

Angiotensin II
:

losartan, irbesartan, valsartan

Angiotensin II AT1

ACEi , but

ANGIOTENSIN II
losartan

( ): 50mg qd
valsartan ( ): 80mg qd
telmisartan ( ): 40mg-80mg qd
irbesartan ( ): 150mg qd
Olmesartan( ): 10mg-40mg qd
*thiazide : .. , ..

: amlodipine, nifedipine, verapamil

Ca2+

,

, , , ,

Felodipine (Munobal ), Amlodipine (Novasc

)
1) 5mg 1 1 10mg
2) - , , ,

3)
- , , , , ,

diltiazem ( ), verapamil (
)

nifedipine ( ): 30-60mg qd