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  • Hypertension is one of the most common medical conditions in the world. It is an important public health problem, with high mortality and morbidity. Rebound hypertension is one complication of this condition.

    Identification

    Rebound hypertension occurs when blood pressure increases as a result of withdrawal from medication that previously had been keeping blood pressure under control. In other words, the condition is caused by the sudden lack of such drugs. When this happens, it is a medical emergency, requiring immediate intervention.

    Background Physiology

    Blood pressure control, even in a healthy individual, is a complicated process because it results from a combination of cardiac output and peripheral vascular resistance, each of which can be influenced by a variety of factors.

    Abnormal Physiology

    An abnormal increase in blood pressure can be caused by an increase in the volume of blood, electrolyte disturbances, kidney problems, metabolic syndrome, eclampsia (a normal condition in pregnancy) and pheochromocytoma, a tumor that secretes the hormone epinephrine. Hypertension is called "essential hypertension" when it is caused by problems in the regulation of blood pressure by way of the kidneys and adrenal glands.

    Selecting Medications

    Drugs are selected based on the cause of ypertension and medical history of the patient. Lists of approved drugs are lengthy and clinical studies continually enable new anti-hypertensive medications to enter the clinic.

    Common Drugs for Hypertension

    Categories of drugs prescribed for hypertension include calcium channel blockers, which help blood vessels to dilate; inhibitors of angiotensin-converting enzyme (ACE inhibitors); and thiazide-type diuretics. Angiotensin II receptor blockers are also sometimes given, as are beta-blockers. Two or more of these drug classes are often given in combination when hypertension is severe.

    Source:

    World Health Organization. 1999 World Health Organization-International Society of Hypertension Guidelines for the Management of Hypertension. Guidelines Subcommittee. J Hypertens. 17(2):151-83.

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