Blood pressure management is a vital part of healthcare, particularly in older adults. Hypertension, defined as systolic blood pressure ≥ 130 mmHg or diastolic blood pressure ≥ 80 mmHg, is a common medical condition that increases the risk of developing cardiovascular diseases, renal disease, and dementia (James et al., 2018). Advanced practice nurses (APNs) play a significant role in managing hypertension in older adults residing in nursing homes. In this post, we will discuss the therapeutic actions of drugs that affect blood pressure and important teaching points for patients receiving antihypertensive drugs.
Diuretics are antihypertensive drugs that act on the kidney to increase the excretion of sodium and water, resulting in decreased plasma volume and blood pressure. There are three types of diuretics: thiazide diuretics, loop diuretics, and potassium-sparing diuretics. Thiazide diuretics are the most commonly used diuretics for hypertension management in older adults due to their low cost and effectiveness in reducing blood pressure (Roush et al., 2018). Loop diuretics and potassium-sparing diuretics are less commonly used in the management of hypertension in older adults.
Angiotensin-converting enzyme (ACE) inhibitors are antihypertensive drugs that block the conversion of angiotensin I to angiotensin II, resulting in vasodilation, decreased aldosterone secretion, and decreased blood pressure. ACE inhibitors are effective in reducing blood pressure, improving heart function, and reducing the risk of cardiovascular events (Roush et al., 2018).
Angiotensin receptor blockers (ARBs) are antihypertensive drugs that block the action of angiotensin II by binding to its receptors. ARBs have similar therapeutic effects to ACE inhibitors but are better tolerated in patients who develop a cough or angioedema when taking ACE inhibitors (James et al., 2018).
Calcium channel blockers (CCBs) are antihypertensive drugs that act by blocking the influx of calcium ions into the cells of the heart and blood vessels, resulting in vasodilation and decreased blood pressure. CCBs are effective in reducing blood pressure and preventing cardiovascular events (Roush et al., 2018).
Sympathetic nervous system drugs are antihypertensive drugs that act on the adrenergic receptors to decrease sympathetic nervous system activity and blood pressure. There are two types of sympathetic nervous system drugs: alpha-blockers and beta-blockers. Alpha-blockers reduce blood pressure by blocking the action of alpha-adrenergic receptors, resulting in vasodilation. Beta-blockers reduce blood pressure by blocking the action of beta-adrenergic receptors, resulting in decreased heart rate and cardiac output (Roush et al., 2018).
When teaching patients receiving antihypertensive drugs, it is essential to emphasize the importance of medication adherence, regular blood pressure monitoring, and potential side effects. Patients should be advised not to abruptly stop taking their antihypertensive medication and to report any adverse effects to their healthcare provider. Patients should also be advised to follow a low-sodium diet, engage in regular physical activity, and limit alcohol intake to optimize blood pressure control (James et al., 2018). Additionally, patients should be educated about the importance of lifestyle modifications, such as smoking cessation and stress reduction, to improve blood pressure control.
In conclusion, the therapeutic actions of drugs that affect blood pressure include diuretics, ACE inhibitors, ARBs, CCBs, and sympathetic nervous system drugs. APNs should ensure that patients receiving antihypertensive drugs are educated on medication adherence, regular blood pressure monitoring, and potential