MEDICINAL CHEMISTRY

Mean Arterial Blood Pressure (MABP): The mean arterial pressure is calculated as:
MABP = [Systolic + (2 × diastolic)] ÷3
According to WHO, the systolic and diastolic blood pressure in normal adult is equal to
or below 140 mm Hg and 90 mm Hg. The blood pressure may be of three types.
Mild hypertension - 90-104mmHg
Moderate hypertension 105-114mmHg
Severe hypertension above 115mmHg
Further, the hypertension has been divided into two categories.
I. General Classification of Hypertension
The widely accepted categorization of systemic hypertension for the basic research
and in the field of clinical medicine was suggested by “Fein-Stein” as follows:
a. Category (1): Essential or primary hypertension: It is a common form of HTN
with no identifiable causes.
b. Category (2): Secondary hypertension: It always occurs because of another
disorder. Patients with HBP with diseases known to its cause are referred as suffering
from secondary hypertension. It might be associated with end organ damage. The
others unusual reasons for this type of HTN are coarctation of aorta, thyroid disorder,
hyperparathyroidism, obstructive sleep apnea, drug-induced HTN and Liddle’s
syndrome.
c. Category (3): It may be consequences of either primary or secondary HTN
manifestation due to anatomical changes in parenchymal organs such as left
ventricular hypertrophy, hypertensive retinopathy or sclerosis of renal arteriolar with
impaired kidney function (i.e. nephrosclerosis).
d. Category (4): Patients with end organ changes from either type of HTN,
subsequently, become normotensive with therapy or with counter-balancing comorbid
diseased sate and may still be considered to suffer from hypertensive disease of end
organ.
e. Category (5): Malignant or accelerated hypertension: It is complex and deadly
forms of HTN related to circulatory and end-organ manifestations like
encephalopathy heart failure, retinopathy and uremia. Other forms of malignant
hypertension are diagnosed on the basis of patho-physiological criteria like arteriolar
necrosis in kidney, elevated secretion of renin and secondary hyperaldosteronism.
II. Other kinds of Hypertension
a. Pulmonary hypertension: It is defined as a pressure within the pulmonary arterial
system, elevated above the normal range. It may be acute or chronic due to right
ventricular (RV) failure. A variety of pathological disorders, which affect the
pulmonary circulatory function, can elevate the pulmonary pressure. For example,
polycythemia vera and increased pulmonary arteriolar resistance in a patient with