KNOW THE COMMON HIGH BLOOD PRESSURE MEDICATIONS
High blood pressure (also called hypertension) is a life-threatening condition that affects 1 in every 4 Americans over age 18. Anyone can get it, and as you get older, the odds of your developing it increase, especially if you are overweight or obese or have diabetes. That is why it is so important to take steps early in life to prevent it. High blood pressure can lead to other life-threatening illnesses such as heart disease, stroke, and kidney disease.
High blood pressure is a major cause of complications in pregnancy.
There are lots of medications used to treat high blood pressure. While many people dealing with hypertension will possibly be prescribed a combination of a variety of these medications, the amount of medication needed depends greatly on the type and the level of severity of the illness.
While antihypertensive medicines are used to lower blood pressure to normal levels, medications should always be used in combination with a healthy lifestyle change. The main objectives of high blood pressure medications are to not only lower blood pressure but to minimize the side effects caused by some of the medicines.
The Common Antihypertensive Medication Are:
Diuretics
Beta Receptor Antagonists (Beta Blockers)
Alpha I Receptor Blockers
Angiotensin Converting Enzyme Inhibitors (Ace-Is)
Angiotensin Ii Antagonists
Calcium Channel Blockers
Direct Vasodilators
Centrally Acting Agents
Combination Therapies.
DIURETICS
The types of diuretics used in clinical practice today are:
Thiazide diuretics
Loop diuretics
Potassium sparing diuretics
Aldosterone receptor blockers.
•Diuretics (also known as “water pills”) act by increasing the kidneys’ excretion of salt and water thus reducing blood volume with a consequent decrease in the pressure in the arteries.
Two of the commoner diuretics in use today are:
Hydrochlorothiazide (Microzide,Hydrodiuril), and Furosemide (Lasix)
Others are:
Acetazolamide (Diamox)
Amiloride (Midamor)
Chlorothiazide (Diuril)
Indapamide (Lozol)
Torsemide (Demadex)
Metolazone (Zaroxolyn)
Spironolactone (Aldactone)
Triamterene (Dyrenium)
Metolazone (Zaroxolyn).
Potential side effects of diuretic usage include increased frequency of urination, increased urinary excretion of potassium, impaired glucose tolerance and increased blood urate levels.
BETA(β)RECEPTOR ANTAGONISTS (beta blockers):
Beta blockers decrease the force of contraction of the heart thus decreasing the force of blood needed to pump blood into the arteries.
Commonly used beta blockers include:
Atenolol (Tenormin)
Bisprolol (Zebeta)
Metoprolol (Lopressor)
Propranolol (Inderal)
Timolol (Blocadren)
Potential side effects of beta blocker usage include decrease in heart rate, constriction (narrowing) of the bronchioles (avoid in asthma), hair loss, depression (rarely), fatigue, and impotence (rarely).
ALPHA 1 RECEPTOR BLOCKERS
Cause relaxation of the smooth muscles in the blood vessels by blockade of the alpha 1 receptors thus allowing blood to pass in these vessels more freely.
Commonly used alpha blockers include:
. Doxaxosin (Cadura)
. Prazosin (Minipress)
. Terazosin (Hytrin)
The major potential side effect of alpha I receptor blocker usage is a sudden decrease in the blood pressure on standing (postural hypotension).
NOTE: Labetalol (Normodyne,Trandate) has both alpha 1 selective and beta-blocking effects. It is particularly useful in treating hypertensive emergencies and hypertension in pregnancy (where first line agents are ineffective or poorly tolerated.
ANGIOTENSIN CONVERTING ENZYME (ACE)INHIBITORS.
Prevent the production of Angiotensin II by inhibiting the enzyme, Angiotensin Converting Enzyme (ACE). Angiotensin II causes the blood vessels to narrow.
Help dilate the arteries, thereby decreasing resistance to blood flow and consequently decreasing blood pressure.
Include Benazepril (Lotensin),Captopril (Capoten),Enalapril (Vasotec),Fosinopril (Monopril), Lisinopril (Zestril,Prinivil), Ramipril (Altace), and Trandolapril (Mavik).
Potential side effects include cough,increased in blood potassium levels, and rarely, swelling of the lips, cheeks and face (angioneurotic edema).
ANGIOTENSIN II ANTAGONISTS
Protect against the arteriolar narrowing effect of angiotensin II.
Help dilate arteries thus lowering blood pressure.
Tend to improve congestive cardiac failure symptoms, decrease the risk of further heart attacks and decreases the risk of death from heart failure.
Include Candesartan (Atacand),Eprosartan (Teveten) Irbesartan (Avapro), Losartan (Cozaar), Olmesartan (Benicar), Telmisartan (Micardis), and Valsartan (Diovan).
Are generally well tolerated.
CALCIUM CHANNEL BLOCKERS (Also known as calcium antagonists)
Divided into 2 broad categories:
. 1,4-dihydropyridines: include Amlodipine (Norvasc),Felodipine (Plendil),Isradipine (DynaCirc),Nifedipine (Procardia,Adalat) and Nisoldipine (Sular).
. Nondihydropyridines: include Diltiazem (Cardizem,Dilacor) and Verapamil (Calan,Veralan,Covera).
Reduce blood pressure by preventing the entry of calcium, needed for muscle contraction and blood vessel narrowing (constriction), into cells.
The overall effect is a decrease in force of contraction of the heart, opening up (dilating) the arteries, decrease in resistance to blood flow, decrease in the pressure in the arteries with a consequent decrease in blood pressure.
Potential side effects include swelling of the hands and feet, swelling of the gums, flushing, nausea and headaches.
DIRECT-ACTING VASODILATORS
Dilate the arteries in the body by direct relaxation of the arteriolar smooth muscles.
Are useful in the treatment of heart failure, specific types of hypertension or in combination with other medication, to achieve blood pressure goals.
Include Hydralazine (Apresoline), Fenoldapam, Sodium Nitroprusside and Minoxidil.
Potential side effects vary with the agent used and include hypotension, nausea, headaches and flushing.
CENTRALLY ACTING AGENTS
Are the oldest class of antihypertensive agents.
Act on the central nervous system and exerts control over nerve impulses that cause arteries to narrow (constrict).
Include Clonidine (Catapres), Methyldopa (Aldomet) and Reserpine.
Potential side effects include drowsiness, nausea, vomiting and depression.
COMBINATION THERAPIES
In the majority of hypertensive patients it is unlikely that a single drug will control blood pressure to target levels.
Clinical trials demonstrate that combination therapy is required in approximately two-thirds of hypertensive individuals.
Potential reasons why single-drug therapies fail include the presence of coexisting conditions such as obesity, diabetes mellitus and kidney disease, non-adherence to therapy, isolated systolic hypertension and unpredictability of the blood pressure response.
The common combination antihypertensives include:
. ACE inhibitor and Calcium channel antagonist e.g Lotrel, Tarka. Triapin
. ACE inhibitors and Diuretic e.g Vaseretic, Zestoretic.
. Angiotensin II receptor blockers and Diuretics e.g Diovan, Hyzaar.
. Beta blockers and Diuretic e.g, Lopressor, Tenoretic. . Diuretic and Diuretic e.g Moduretic, Maxzide.
Centrally acting agent and Diuretic e.g Regroton, Aldoril
