Ipertensione da farmaci
Ipertensione da farmaci
Che cos’è l’ipertensione da farmaci
Numerosi sono i farmaci che, in via diretta o indirettamente, sono in grado di indurre ipertensione. Rappresentano una causa piuttosto frequente di ipertensione secondaria ed è opportuno documentarne l’assunzione al momento dell’anamnesi.
Quali sono i faramci che possono causare ipertensione?
- Corticosteroidi:sono dotati di attività mineralattiva, di entità maggiore o minore in rapporto ai diversi tipi di molecole di sintesi. Il meccanismo è analogo a quello responsabile della Sindrome di Cushing.
- Carbenoxolone:si tratta di un farmaco antiulceroso, ad attività molto simile, anche se inferiore per quanto concerne la potenza, all’ aldosterone.
- Liquirizia: l’acido glicirrizico, in esso contenuto , è dotato di attività aldosteronica.
- Inibitori delle monoaminossidasi (I-MAO): utilizzati nella terapia delle sindromi depressive, possono scatenare attività ipertensiva di amine assunte con la dieta (tiramina). Tali sostanze sono presenti infatti in alcuni tipi di formaggi fermentati, numerosi sciroppi per la tosse, inoltre, contengono un’amina, la fenilpropolamina, anch’essa ipertensiva se assunta in concomitanta agli I-MAO.
- Contraccettivi orali: i contraccettivi orali contenenti estrogeni possono, non infrequentemente, indurre ipertensione. il fenomeno sembra legato ad un’attivazione, per aumentata sintesi dei precursori a livello epatico, del sistemata renina-angiotensina-aldosterone
Sospensione farmaci ipotensivi
Una crisi ipertensiva può infine essere scatenata dalla brusca sospensione di farmaci ipotensivi. La clonidina , per esempio, può ridurre i livelli pressori con un’azione a livello centrale associata a riduzione della produzione periferica di catecolamine.Il ripristino di livelli elevati di catecolamine, che fa seguito alla sospensione repentina del farmaco, può essere causa di una crisi ipertensiva del tutto simile a quella propria del feocromocitoma.
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Ipertensione
La pressione sanguigna è il risultato dell’eiezione da parte del ventricolo sinistro del cuore in un minuto (gittata cardiaca) tale da consentire il flusso di sangue negli organi e nei muscoli, in modo da mantenerli in uno tato di eutrofismo tramite il sistema arterovenoso, per le resistenze periferiche. Epidemiologia L’ipertensione è un problema … Leggi tutto
L’ipertensione considerata un “killer silenzioso” rappresenta un gravissimo fattore di rischio per le malattie cardiovascolari e l’ictus. Per questi motivi si raccomanda di affrontarla tempestivamente e di intraprendere la terapia giusta su parere del medico. L’obiettivo primario del trattamento del paziente iperteso è quello di ottenere la massima riduzione del rischio di mortalità e morbilità cardiovascolare a … Leggi tutto
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