Modern blood pressure medications are divided into 10 different groups depending on their mechanism of action. The doctor, after studying the patient's complaints and test results, will prescribe one or more drugs, which in no case should be changed independently. Heart and blood vessel medications are not drugs you can "recommend to a friend. "One wrong choice can lead to dire consequences. Antihypertensive medications are available by prescription. In this article we will consider their modern classification based on the active ingredients and nature of the effect on the body.
People often ask pharmacies for new generation blood pressure medications that have no side effects. But this does not happen in reality. All effective medications have side effects. You will have to spend a lot of time with your doctor to choose a group of drugs to treat high blood pressure. Check, adjust dosage or completely replace if the medicine is not suitable.
Classification of drugs for treating high blood pressure (BP)
Diuretics or diuretics
Medicines that enhance kidney function remove excess salt and water. This leads to a decrease in blood circulation and a decrease in vascular resistance - a decrease in pressure. Not all diuretics are suitable for this purpose. The main requirements for these drugs are the mildness and duration of the diuretic effect as well as the ability to conserve potassium. Many drugs in this group are included in the group of combination drugs used to treat hypertension.
The most common is thiazide. Drugs based on indapamide are available in pure and complex forms. Hydrochlorothiazide and chlorthalidone are commonly found in blood pressure medications. For example: chlorthalidone + atenolol, chlorthalidone + azilsartan. Many options include hydrochlorothiazide complexes with various substances that treat hypertension: with quinapril, ramipril, candesartan, bisoprolol, losartan, valsartan. Indapamide is more common with lisinopril, amlodipine and perindopril.
When diuretics are prescribed properly by a doctor, side effects are practically non-existent. The amount of potassium lost is insignificant. Sometimes patients have to change their medications due to an allergic reaction. In some cases, your doctor may prescribe potassium supplements.
It happens that one diuretic is not enough. There is a medication that includes two diuretics: hydrochlorothiazide and triamterene (potassium sparing). The indications for this remedy are as follows: edematous syndrome, cirrhosis and hypertension.
Drugs 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 characterize its action, but will only say that the main active ingredient that increases blood pressure is angiotensin II oligopeptide. When a person has vascular imbalance, angiotensin is inhibited. A large group of drugs has been developed for this purpose.
Generations of blood pressure medications that affect angiotensin II are continuously updated. Many well-known and popular treatment methods have become obsolete and are being replaced by more modern and effective methods.
It begins to act after about 1 hour and works throughout the day. It is considered a powerful medicine. For this reason, it is difficult for many people to adjust the dosage, it is impossible to do this without a doctor. A special side effect is an excessive drop in blood pressure, which is very dangerous. Sometimes the cardiologist is forced to completely stop a drug from this group. But for severe headache symptoms, perindopril is ideal, especially when combined with indapamide. Cough and shortness of breath with perindopril are less common and less pronounced than with enalapril.
ACE blockers
The newest drugs to treat blood pressure without side effects such as cough are ACE blockers, which work in a similar way but are safer. These are candesartan, eprosartan, irbesartan, losartan, telmisartan. Valsartan is no longer considered new.
Sartans reduce blood pressure after 3 hours, but maximum effect is achieved after 4-8 weeks of continuous use. Correct use of this medication reduces the risk of death in patients at high risk of cardiovascular diseases. ACE blockers in the sartan class are more expensive than ACE inhibitors because they work more selectively and are better tolerated.
Beta and alpha adrenergic blockers
This group of drugs works by reducing the action of adrenaline, which increases blood pressure and the frequency and strength of heart contractions. Adrenergic blockers are prescribed for people who do not respond to ACE inhibitors, as well as for patients with heart disease. Several generations of drugs are distinguished here. The earliest of them were drugs based on the substances atenolol and metoprolol. Now doctors prescribe drugs with the active ingredient bisoprolol fumarate, alone or in combination with a diuretic component.
This medication works mainly through the heart, causing a small decrease in blood volume. It also affects blood vessels and renin activity. As a result, blood pressure and heart rate decrease. Prescribed for chronic heart failure, prevention of angina attacks and anti-hypertension. Potentially dangerous side effects: low pulse, dizziness, cardiac conduction disorders.
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 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 better vasodilation effect and higher safety.
Calcium blockers
Calcium normally maintains myocardial contractility and vascular tone. A group of drugs has been developed to limit its effects to lower blood pressure in hypertensive patients.
Calcium channel blockers are considered potent and are sometimes prescribed as an emergency treatment for high blood pressure.
Preparations based on the active ingredient amlodipine besylateprescribed for hypertension and angina. Side effects often include low blood pressure, palpitations, swelling, and impaired heart function. Medicines containing lercanidipine hydrochloride reduce blood pressure mainly through the vascular bed and therefore have no cardiac side effects or they are less pronounced. Among the signs is only increased blood pressure.
Imidazoline receptor agonist
This new group of blood pressure medications is called central alpha 2 adrenergic agonists.
As we mentioned above, the important support of pressure in the vascular bed is under the control of many systems in our body. One of them is the vasomotor center in the brain. The representative of the group is the substance moxonidine, which reduces the activity of this center and the pressure decreases, the process occurs gradually.
Drugs based on moxonidine qualitatively reduce blood pressure. But unlike other substances, this substance is contraindicated in acute and chronic heart failure, and these pathologies are often accompanied by hypertension.
Unwanted effects include dry mouth, diarrhea, drowsiness, headache, insomnia and nervousness.
As we can see, there are no new blood pressure medications without side effects. The choice of medication will be made by the doctor based on the study of blood tests, electrocardiogram and blood pressure measurements. Before seeing your doctor, you need to keep a diary of your blood pressure values, in which blood 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 activities will have a positive effect.
To improve the functioning of the cardiovascular system, we can recommend nutritional supplements that contain important ingredients. For example: selenium, magnesium, potassium. They are contained in many popular dietary supplements and vitamin complexes.
Supplementing your diet with omega 3 supports blood vessel health and regulates blood pressure. There are many medicines available in pharmacies.