Modern blood pressure medications 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 drugs, which in no case should be changed independently. Cardiovascular medications are not something you can "recommend to a friend. "A wrong choice can lead to dire consequences. Antihypertensive drugs 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 look to pharmacies for new generation blood pressure drugs 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 with your doctor to choose your group of drugs for hypertension. 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 excess salts and water. This leads to a decrease in the volume of circulating blood and a decrease in vascular resistance - the pressure drops. Not all diuretics are suitable for this purpose. The main requirement for such drugs is the mildness and duration of the diuretic effect, as well as the ability to conserve potassium. Many drugs from this group are included in combined medications 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. The many options include a complex of hydrochlorothiazide with various substances for hypertension: with quinapril, ramipril, candesartan, bisoprolol, losartan, valsartan. Indapamide is most commonly used with lisinopril, amlodipine and perindopril.
When diuretics are correctly prescribed by a doctor, side effects practically do not exist. Potassium losses are not significant. Sometimes the patient needs to change medications because of 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 sparing). The indications for this drug are as follows: edema syndrome, cirrhosis of the liver 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 describe the features of its work, but we will only say that the main active substance that increases blood pressure is the oligopeptide angiotensin II. When a person experiences a disruption of vascular balance, angiotensin must be inhibited. A large group of drugs has been created for this purpose.
Generations of blood pressure drugs that affect angiotensin II are constantly updated. Many well-known and well-known drugs are already becoming obsolete and are being replaced by more modern and more effective means.
It begins to work in about 1 hour and is active throughout the day. It is considered a strong medicine. For this reason, many find it difficult to adjust the dose; this is impossible to do without a doctor. A particular side effect is an excessive drop 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. Coughing and shortness of breath when taking perindopril are much less common and less severe than when taking enalapril.
ACE blockers
Newer blood pressure drugs without side effects such as cough are ACE blockers, they work in a similar way but have a higher safety profile. These are candesartan, eprosartan, irbesartan, losartan, telmisartan. Valsartans are no longer considered novel.
Sartans lower blood pressure after 3 hours, but the maximum effect occurs after 4-8 weeks of continuous use. The proper use of this drug 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, 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. Several generations of drugs are distinguished here. The earliest of them were drugs based on the substances atenolol and metoprolol. Doctors now prescribe medications with the active ingredient bisoprolol fumarate, alone or in combination with a diuretic ingredient.
This medication works mainly through the heart, reducing the small volume of blood. 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 disorders.
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 strong medicine. It reduces the pressure through the heart and peripheral vessels, expanding them. Prescribed for the treatment of stable angina, chronic heart failure and hypertension.
Nebivolol is a third generation beta blocker. It has a better vasodilating effect and a higher safety profile.
Calcium channel blockers
Calcium normally maintains myocardial contractility and vascular tone. A group of drugs has been created that limit its effect to lower blood pressure in hypertension.
Calcium channel blockers are considered strong and are sometimes prescribed as an 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 the substance lercanidipine hydrochloride lower blood pressure mainly through the vascular bed and therefore have no 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 drugs are called central alpha 2 adrenergic agonists.
As we mentioned above, the vital pressure support 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, the substance moxonidine, reduces the activity of this center and the pressure decreases, the process occurs gradually.
Medicines based on moxonidine qualitatively lower blood pressure. But unlike the 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 blood pressure drugs 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 going to the 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 with little salt, animal fats and light carbohydrates, as well as regular sports activities, have a positive effect.
To improve the functioning of the cardiovascular system, we can recommend food supplements with important elements. For example, selenium, magnesium, potassium. They are contained in many popular nutritional supplements and vitamin complexes.
Dietary supplement with omega 3 supports the health of blood vessels and regulates blood pressure. There is a wide variety of drugs available in pharmacies.