Modern blood pressure medications are divided into 10 different groups based on their mechanism of action. The doctor, after studying the patient's complaints and test results, prescribes one or more medications, which in no case should be changed on his own. Medications for the heart and blood vessels cannot be "recommended to a friend. "A wrong choice can have dire consequences. All antihypertensive medications are available with a prescription. In this article we will consider their modern classification depending on active substances and the nature of the effect on the body.
People often order new generation blood pressure medications without side effects from pharmacies. But this does not happen in practice. All effective medications have their side effects. You will have to spend a lot of time choosing your group of hypertension medications with your doctor. Try it, adjust the dosage, or replace it entirely if the medication is not suitable.
Classification of drugs for high blood pressure (BP)
Diuretics or diuretics
Medications that improve kidney function eliminate salts and excess water. This leads to a decrease in circulating blood volume and a decrease in vascular resistance - pressure drops. Not all diuretics are suitable for this purpose. The main requirement for these drugs is the mildness and duration of the diuretic effect and the ability to preserve potassium. Many drugs in this group are included in combination drugs for hypertension.
The most common are thiazides. The drug based on the substance indapamide is available in pure and complex form. Hydrochlorothiazide and chlorthalidone are commonly found in blood pressure medications. Examples: substances chlorthalidone + atenolol, chlorthalidone + azilsartan. Numerous options include a complex of hydrochlorothiazide with different substances for hypertension: with quinapril, ramipril, candesartan, bisoprolol, losartan, valsartan. Indapamide is most common with lisinopril, amlodipine, and perindopril.
When a doctor correctly prescribes diuretics, side effects are virtually non-existent. Potassium losses are not significant. Sometimes a patient has to change medications due to an allergic reaction. In some cases, your doctor may prescribe potassium supplements.
It happens that one type of diuretic is not enough. There is a drug that includes two diuretics: hydrochlorothiazide and triamterene (potassium saver). The indications for this remedy are the following: edema syndrome, liver cirrhosis and hypertension.
Medications that affect angiotensin-converting enzyme (ACE) activity
Several systems work simultaneously in our body to maintain normal blood pressure. One of them is the renin-angiotensin system. We will not describe the features of its work, we will only say that the main active ingredient that increases blood pressure is the oligopeptide angiotensin II. When a person experiences a disturbance in vascular balance, angiotensin must be inhibited. For this purpose, a large group of drugs has been developed.
Generations of blood pressure medications that affect angiotensin II are continually updated. Many well-known and popular remedies are already becoming obsolete and are being replaced by more modern and effective ones.
It starts acting in about 1 hour and is active throughout the day. It is considered a strong drug. For this reason, many find it difficult to adjust the dosage; it is impossible to do this without a doctor. A particular side effect is an excessive decrease in blood pressure, which is dangerous. Sometimes the cardiologist is forced to completely discontinue a drug from this group. But for severe headache symptoms, perindopril is an ideal choice, especially in combination with indapamide. Cough and shortness of breath when taking perindopril are much less common and less pronounced than when taking enalapril.
ACE blockers
The newer blood pressure medications without side effects like cough are ACE blockers, they work in a similar way, but have a higher safety profile. These are candesartan, eprosartan, irbesartan, losartan and telmisartan. Valsartans are no longer considered new.
Sartans lower blood pressure after 3 hours, but the maximum effect occurs after 4 to 8 weeks of continuous use. The proper use of this medication reduces the risk of mortality in patients at high risk of cardiovascular pathologies. ACE blockers from the sartan group are more expensive than ACE inhibitors because they act more selectively and are better tolerated.
Beta and alpha adrenergic blockers
This group of drugs works by reducing the activity of adrenaline, which increases blood pressure and the frequency and strength of heart contractions. Adrenergic blockers are prescribed to people who do not respond to ACE inhibitors, as well as patients with heart disease. Several generations of drugs are distinguished here. The first were medications based on the substances atenolol and metoprolol. Doctors now prescribe medications with the active ingredient bisoprolol fumarate, alone or in combination with a diuretic component.
This drug acts primarily through the heart, reducing minute blood volume. It also affects blood vessels and renin activity. As a result, blood pressure and heart rate decrease. Prescribed for chronic heart failure, to prevent angina attacks and to combat hypertension. Side effects can be dangerous: low pulse, dizziness, cardiac conduction disturbances.
Carvedilol has a combined adrenergic blocking effect. It is an alpha and beta adrenergic blocker. It belongs to a new generation and is considered a powerful drug. It reduces pressure through the heart and peripheral vessels, dilating them. Prescribed for the treatment of stable angina, chronic heart failure, and hypertension.
Nebivolol is a third generation beta blocker. It has a better vasodilator effect and a higher safety profile.
Calcium channel blockers
Calcium normally maintains myocardial contractility and vascular tone. A group of drugs has been developed that limit their effect to reduce blood pressure in hypertension.
Calcium channel blockers are considered powerful and are sometimes prescribed as an emergency treatment for very high blood pressure.
Preparations based on the substance amlodipine besylate.prescribed for hypertension and angina pectoris. Side effects typically include hypotension, palpitations, swelling, and impaired cardiac function. Medicines containing the substance lercanidipine hydrochloride lower blood pressure mainly through the vascular bed and therefore have no or much less pronounced side effects on the heart. Among the indications is only hypertension.
Imidazoline receptor agonists
This group of new blood pressure medications is called central alpha 2 adrenergic agonists.
As we mentioned above, life support pressure in the vascular bed is under the control of many systems in our body. One of them is the vasomotor center of the brain. The representative of the group, the substance moxonidine, reduces the activity of this center and the pressure decreases, the process occurs gradually.
Medicines based on moxonidine qualitatively reduce blood pressure. But unlike others, this substance is contraindicated in acute and chronic heart failure, and these pathologies usually accompany hypertension.
Undesirable effects include dry mouth, diarrhea, drowsiness, headache, insomnia, and nervousness.
As we can see, there are no new blood pressure medications that do not have side effects. The choice of medication will be made by the doctor based on the study of blood tests, ECG and tonometer readings. Before visiting a doctor, it is necessary to keep a diary of blood pressure values, where the pressure will be recorded in the morning, afternoon and evening.
Adherence to a diet low in salt, animal fats and light carbohydrates, as well as regular sports practice, has a positive effect.
To improve the functioning of the cardiovascular system, we can recommend nutritional supplements with important elements. For example, selenium, magnesium, potassium. They are contained in many popular dietary supplements and vitamin complexes.
The dietary supplement with omega 3 promotes vascular health and regulates blood pressure. There is a wide variety of medications available in pharmacies.