Drugs Acting on the Cardiovascular System

Antihypertensive drugs are used commonly in anaesthesia and intensive care medicine. Patients might require antihypertensive drugs before surgery for the treatment of essential hypertension, pre-eclampsia or, occasionally for conditions such as phaeochromocytoma; during surgery as part of a deliberate hypotensive anaesthetic technique; or to reduce postoperative cardiovascular complications. Here, we discuss the physiology of blood pressure control, the pharmacology of antihypertensive drugs, current guidelines, and practical applications of antihypertensive therapy.Keywords antihypertensive agents; autonomic nervous system; blood pressure; hypertension; renin-angiotensin system; vasomotor system Introduction Arterial pressure is modulated by the interaction among vessel tone, blood volume, and cardiac function, which are regulated by local and nervous mechanisms. Local mechanisms include metabolites that influence vascular tone and blood flow within tissues. Nervous mechanisms control the distribution of blood throughout the body, as well as coordination of cardiac output, heart rate, and contractility. The autonomic nervous system (ANS) is controlled by centres in the spinal cord, brainstem and hypothalamus, which are influenced by higher centres. The renin-angiotensin system (RAS) affects vascular tone and excretion of sodium and water in response to changes in circulating volume and arterial pressure. Blood pressure can be manipulated by drugs acting at several of these sites (Figure 1).

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Drugs Acting on the Cardiovascular System

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Drugs acting on the heart: antihypertensive drugs

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