Chapter 6 Drugs for Cardiovascular Arrhythmias and Hypertension

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Chapter 6 Drugs for Cardiovascular Arrhythmias
and Hypertension
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• Hank Gathers
• hypertrophic cardiomyopathy
• Flo Hyman
• Marfans syndrome
• Jim Fixx
• atherosclerotic coronary artery disease
• Darryl Kile
• atherosclerotic coronary artery disease

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• Pistol Pete Maravich
• abnormal coronary arteries
• Len Bias
• illegal drugs
• High School versus College Athlete
• Changing cardiovascular development

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Arrhythmias

• Irregular heart action caused by physiological
  or pathological disturbances in the discharge of
  cardiac impulses from the sinoatrial node or
  their transmission through conductive tissue of
  the heart.

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Arrhythmias

• Medications control arrhythmias and assist the
  heart in maintaining a normal rhythm
• Device-based techniques
• Implantable pacemakers or defibrillators
• Can result in syncope, fatal in certain sports
• Table 6-1, pg 82

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Arrhythmias

• Common Forms of Arrhythmias
• Table 6-2,pg 83

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Arrhythmia Medications

• Four subclassifications
• Class I Sodium channel blockers
• Class II ß-adrenergic blockers
• Class III Potassium channel blockers
• Class IV Calcium channel blockers

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Adverse Effects

• Lethargy
• Fatigue
• Bradycardia
• Orthostatic hypotension
• Cold extremities
• Rashes, pruritus, headache, nausea, diarrhea,
  swelling, behavioral disturbances, disorientation

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Adverse Effects (cont.)

• Despite the purpose of reducing arrhythmias one
  of the most common side effects of the anti
  arrhythmic drugs is the increase in rhythm
  disturbances.

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Antiarrhythmic Drug Interactions

• Table 6-3, pg 85

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Device Therapy

• Pacemakers first implanted (1958)
• Implantable cardioverter defibrillators (ICD)
  (1980)
• Not common in athletes

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Hypertension

• Hypertension is the pressure in the pipes
• Diet, stress, genetics, etc.
• Approximately 24 of population
• Females have higher rates
• BP gt 140 mm Hg
• on three separate occasions
• Essential hypertension
• No known cause
• Secondary hypertension
• Diagnosable cause

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BP Classifications

• Normal lt120/lt80
• Prehypertension 120 139/8089
• Hypertension
• Stage 1 140 159/90 99
• Stage 2 gt160/gt100
• Stage 3 Physicians care

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Monitor variables that can affect BP

• Salt and intake of high-sodium and high-fat foods
  (PJ)
• Alcohol
• Over-the-counter stimulants - caffeine/cold
  medication
• Diet pills
• Smoking or chewing tobacco
• Cocaine or anabolic steroids

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Medications for Hypertension

• Diuretics
• Calcium channel blockers
• ACE Inhibitors
• Angiotensin II blockers
• Beta blockers
• Alpha-blockers

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Adverse Effects

• Diuretics
• Orthostatic hypotension
• Dehydration electrolyte imbalance
• ACE inhibitors
• Cough
• Beta blockers
• Bradycardia, fatigue, dizziness
• Alpha-blockers
• Tachycardia/orthostatic hypotension

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Hypertension in the Athlete/Active Population

• Table 6-6, pg 88

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What to Tell the Athlete

• Page 88