timer Asked: Oct 17th, 2018
account_balance_wallet $9.99

Question Description

What antihypertensive would be preferred in each of the situation below:

A patient with a history of myocardial infarction

A patient with atrial fibrillation

An African American patient with diabetes

An elderly patient that is otherwise healthy..

Use APA references

scholarly Articles (5 years min.

Tutor Answer

School: UC Berkeley




Institutional Affiliation



A Patient with a History of Myocardial Infarction
According to Dunn, (2013), the presence of hypertension is initially established and the
patient’s clinical and hemodynamic status is assessed. In case evidence of heart failure is found,
the therapy initiated should be aimed at reducing vascular resistance as well as ventricular filling
pressure. Pure arteriolar dilators like minoxidil and hydralazine should be avoided due to their
capacity to reflexively increase the heart rate and myocardial contractility as shown in Dunn,
(2013). Nitroprusside and nitroglycerine have venodilating properties and have minimal
reflexive impact, they should be considered. In case heart failure is not detected, a less
aggressive therapy is considered to control arterial pressure. Any observed elevations of pressure
should be treated using nitroglycerine and nitroprusside. Dunn, (2013) continues to show how
oral antihypertensive drugs should be administered with caution during the post infarction state.

A Patient with Atrial Fibrillation
Widimský, (2012) shows that for hypertensive patients presenting with AF, the primary
consideration is achieving normal BP levels. This is attributed to the high risk for CV,
particularly stroke. Although antihypertensive agents are administered for reducing the risk of
AF by decreasing blood pressure, there are other individual mechanisms like the impact on
sympathetic nervous system. As shown in Widimský, (2012), the ultimate goal will be reducing
blood pressure. Renin angiotensin aldosterone system blockers are administered for reducing the
risk for AF. This is especially important for high risk patients, especially ones presenting with



left ventricular dysfunction, and survivors of myocardial infarction. Beta-blockers have been
proven effective for controlling heart rate. Their importance has also been shown in mainten...

flag Report DMCA

awesome work thanks

Brown University

1271 Tutors

California Institute of Technology

2131 Tutors

Carnegie Mellon University

982 Tutors

Columbia University

1256 Tutors

Dartmouth University

2113 Tutors

Emory University

2279 Tutors

Harvard University

599 Tutors

Massachusetts Institute of Technology

2319 Tutors

New York University

1645 Tutors

Notre Dam University

1911 Tutors

Oklahoma University

2122 Tutors

Pennsylvania State University

932 Tutors

Princeton University

1211 Tutors

Stanford University

983 Tutors

University of California

1282 Tutors

Oxford University

123 Tutors

Yale University

2325 Tutors