Modern drugs for hypertension are divided into 10 different groups according to their mechanism of action. The doctor, after studying the patient's complaints and test results, prescribes one or more medications that should in no case be changed independently. Medications for the heart and blood vessels are not ones you can "recommend to a friend. "A wrong choice can have disastrous consequences. Antihypertensive medications are all available by prescription. In this article we will consider their modern classification based on active substances and the nature of the effect on the body.
People often ask pharmacies for new generation blood pressure medications without side effects. But this does not happen in practice. All effective medications have their side effects. You will need to spend a lot of time choosing your group of blood pressure medications with your doctor. Test it, adjust the dose, or replace it completely if the medication is not suitable.
Classification of drugs for high blood pressure (BP)
Diuretics or diuretics
Medicines that improve kidney function remove 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, as well as the ability to retain potassium. Many drugs from this group are included in combined drugs for hypertension.
The most common are thiazides. The drug based on the substance indapamide is available in pure form and in complex form. Hydrochlorothiazide and chlorthalidone are commonly found in blood pressure medications. Examples: substances chlorthalidone + atenolol, chlorthalidone + azilsartan. Many options include a hydrochlorothiazide complex with different substances for hypertension: with quinapril, ramipril, candesartan, bisoprolol, losartan, valsartan. Indapamide is more common with lisinopril, amlodipine and perindopril.
When diuretics are properly prescribed by a doctor, side effects are virtually non-existent. Potassium losses are not significant. Sometimes a patient needs to change medications due to an allergic reaction. In some cases, your doctor may prescribe potassium supplements.
Sometimes one type of diuretic is not enough. There is a medication that includes two diuretics: hydrochlorothiazide and triamterene (potassium sparing). Indications for this remedy are: edema syndrome, liver cirrhosis and hypertension.
Drugs affecting 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, but 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. A large group of drugs has been developed for this purpose.
Generations of hypertension medications affecting angiotensin II are continually being updated. Many known and popular remedies are already obsolete and are being replaced by more modern and effective ones.
It starts working in about 1 hour and is active throughout the day. It is considered a powerful drug. For this reason, many find it difficult to adjust the dosage, without the help of a doctor this is impossible. A particular side effect is an excessive decrease in blood pressure, which is dangerous. Sometimes the cardiologist is forced to completely stop 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 newest blood pressure medications without side effects such as coughing are ACE blockers, they work the same way, but they have a higher safety profile. These are candesartan, eprosartan, irbesartan, losartan, telmisartan. Valsartans are no longer considered new.
Sartans reduce blood pressure after 3 hours, but the maximum effect occurs after 4-8 weeks of continuous use. 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 force of heart contractions. Adrenergic blockers are prescribed to people who do not respond to ACE inhibitors, as well as to patients with heart disease. There are several generations of drugs here. The first of them were drugs based on atenolol and metoprolol. Now doctors prescribe medications containing the active ingredient bisoprolol fumarate, alone or in combination with a diuretic component.
This medication works primarily through the heart, reducing blood volume to tiny amounts. Also affects blood vessels and renin activity. As a result, blood pressure and heart rate decrease. Prescribed in cases of chronic heart failure, to prevent angina attacks and fight against hypertension. Side effects can be dangerous: weak pulse, dizziness, cardiac conduction disturbances.
Carvedilol has a combined adrenergic blocking effect. It is an alpha and beta adrenergic blocker. Belongs to a new generation and is considered a powerful medicine. Reduces pressure in the heart and peripheral vessels by 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 to limit its effect in order to lower blood pressure in cases of hypertension.
Calcium channel blockers are considered powerful and are sometimes prescribed as emergency treatment for high blood pressure.
Preparations based on the substance amlodipine besylateprescribed for hypertension and angina pectoris. Side effects often include hypotension, palpitations, swelling, and worsening heart function. Medicines containing lercanidipine hydrochloride reduce blood pressure mainly through the vascular bed and therefore do not have side effects on the heart or are significantly less pronounced. Among the indications, there is only hypertension.
Imidazoline receptor agonists
This group of new blood pressure medications is called alpha 2 central adrenergic agonists.
As we mentioned above, the vital support of 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 proceeds 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 often accompany hypertension.
Side effects include dry mouth, diarrhea, drowsiness, headache, insomnia, and nervousness.
As we can see, there are no new medications for hypertension without 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, you should 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 sporting activity, have a positive effect.
To improve the functioning of the cardiovascular system, we can recommend nutritional supplements containing important elements. For example, selenium, magnesium, potassium. They are contained in many popular dietary supplements and vitamin complexes.
The omega 3 food supplement supports vascular health and regulates blood pressure. There is a wide variety of medications available in pharmacies.