Once it is definitively established, it needs to be treated with appropriate medications, diet, or changing lifestyle habits. Insufficient treatment poses a serious risk, and doctors rightly call it a “silent killer”.
Yes, you already know that it is hypertension or high blood pressure. However, if it is under good and constant control, and treated with appropriate medication choices, the risk of causing heart attacks or perhaps strokes is drastically reduced.
Therefore, in the text that follows, we introduce you to the high blood pressure medication list, its effects, and ways of consuming them.
Here are some quick links to what we’ll cover in this article. If you’re in hurry, or for any other reason, feel free to use the quick links to jump straight to the section you want to read:
- There is something as successful as medicine
- How to choose the type of medicine?
- What types of medicines exist?
- Calcium antagonists
- ACE (Angiotensin-converting enzyme) inhibitors
- The vaccine?
- One of the longer conclusions (with reason)
Drug therapy is applied immediately if there is a risk of possible complications; But changing important life habits can make the use of drugs superfluous. Lifestyle changes can often lower blood pressure as successfully as medication.
In practice, patients more conscientiously follow the instructions if they are informed about how the medicine they should take works. Physicians should never fail to write what they are advised in a report that patients take with them. This is especially true for chronic patients because their treatment is usually lifelong.
There is currently no ideal cure for high blood pressure, but it is possible to make an optimal scheme for each patient if he follows the appropriate principles of treatment. This means not just one medicine, but to make the appropriate combination of medicines for each patient.
It all starts with dietary advice: less salty foods, quit smoking, limit alcohol consumption, and sometimes just losing weight is enough.
If that is not enough after a few weeks, one or more medications are prescribed. Whichever of them is used, it must be taken every day, and blood pressure must be checked regularly, and occasional check-ups with a doctor are necessary.
Namely, the drugs do not cure hypertension, but only maintain the pressure at a normal level, which in any case reduces the risk of possible complications.
The choice of medicine and dosage depends on the assessment of the doctor, who, taking into account all the elements, decides on the appropriate one. Today, drugs from five different groups are used.
By using the drug from only one group (monotherapy), stabilization of blood pressure is achieved in most cases. If there was no success, another drug is added, but always from another group.
With this combination therapy, success is achieved – stabilization of pressure in 90% of patients, while in the remaining 10% a third drug is introduced.
Long-term treatment, for sure, relieves the heart and arteries and thus eliminates the possibility of a fatal outcome. Drugs for lowering have significantly reduced the mortality rate of heart patients.
Modern drugs against high blood pressure are classified according to the way they work in as many as ten groups. However, the following four groups are leading:
- Diuretics – increase urine output and reduce the amount of blood circulating in blood vessels
- Beta-blockers – slow down the heart rate and slightly reduce the strength of heart contractions by blocking the sympathetic nervous system and adrenaline
- Calcium antagonists – prevent the entry of calcium into cells and thus allow the spread of arterioles, which lowers blood pressure
- ACE inhibitors (Angiotensin-converting enzyme), which prevent a single substance from constricting blood vessels, resulting in a reduction in blood pressure
Other medicines belong to diverse groups and are of lesser importance today in the treatment of hypertension.
These are agents that increase the excretion of water and salt from the body, through the kidneys, so that in the first days of therapy, the amount of excreted urine increases.
With normal drinking of water, it causes a decrease in the volume of blood that the heart pumps into the bloodstream, and in that way, the thrust is reduced, which results in a decrease in blood pressure.
The main ingredient in salt is sodium, which contributes to high blood pressure. By taking diuretics, salt, or sodium, will be excreted.
These drugs, in principle, have an advantage in the elderly, especially in cases of “senile hypertension” and edema (swelling) of cardiac origin.
However, this does not exclude their use in younger people. If it turns out that monotherapy (diuretic alone) is not enough, then a combination of two or three drugs is used (but from other groups, whose effects complement each other). When used concomitantly, diuretics increase the effect of other drugs to lower blood pressure.
The goal is to achieve the effect in small doses and with a lower risk of side effects. This explains why a combination of two or three drugs is so often used in practice.
Taking diuretics should be the first step in treating blood pressure, in order to prevent a heart attack. These drugs provide better protection against calcium channel blockers and ACE (Angiotensin-converting enzyme) inhibitors. Patients treated with diuretic hypertension were 40% less likely to end up in the hospital or die of a heart attack.
During longer treatment, the difference in the effectiveness of diuretics and ACE inhibitors disappeared, but calcium blockers are still less effective in protecting against heart attack. The superiority of diuretics over other drugs can be explained by the fact that they reduce the amount of blood that passes and burdens the heart.
In hypertensive patients with edema (swelling) of cardiac origin, they help to reduce the volume of fluid in the body. For these reasons, they are among the most commonly used drugs. Some preparations from this group have a prolonged effect, so they are taken only once every day or even once in two or three days.
Mild or thiazide are most often used, their effect is gradual and lasts long enough (from 12 to 24 hours) with very few side effects. These include monozide and hydrochlorothiazide. They reduce the risk of stroke by over 30%.
Which are the best and recommended?
Strong diuretics are much more effective, their effect is faster and lasts shorter (Urinex, Lasix, Elderkin).
Potassium-sparing ones are the least effective (Aldactone and Aldactone 100) and combine with others.
Loss of this mineral is one of the side effects of taking this medicine, because along with sodium, potassium, which is a very important bio element, is also eliminated.
Consequences of loss of this mineral include constipation, rapid fatigue, muscle cramps, and weakened appetite. This loss is especially dangerous for patients who also take medications against heart failure – cardiotonic (Dilacor, Dimecor, Lanicor). Both the patient and the doctor should take care of that.
In addition, the patient should take foods that are rich in potassium: fruits, fruit juices, tomatoes, bananas, yeast, potatoes, and green vegetables. If the doctor expects a greater loss, in addition to the instructions regarding nutrition, the patient should be prescribed medications that contain potassium (Recavan potassium Citricum) or those that save potassium (Moduretic, Lametazide, Hemopress).
Despite all the side effects, diuretics are still given as the first medicine in hypertension, together with beta-blockers. This combination has shown the best results so far in the treatment of this disease.
These drugs are used especially in younger patients. In them, increased activity of the sympathetic nervous system is more often noticed as a reaction to the appearance of stress or the existence of increased irritability.
They also work well in older people, especially if there is another reason for their use – angina pectoris or arrhythmia, because they have a mildly depressive effect, and do not dilate blood vessels.
The antihypertensive effect of these drugs is unique. They slow down the heart rate, to a heart rate of 50 to 60 beats per minute. (this slowing is called bradycardia). Its effect on the heart muscle reduces the strength of heart contractions, and thus the need for oxygen. It does not interfere with the function of the heart as a pump if the heart muscle is undamaged.
All this results in lowering blood pressure. The advantage of these drugs is that this reduction occurs gradually, over several days. Lower (diastolic) pressure can decrease by about 10 to 20 mmHg with a slowing of the heart rate by 16 to 20 beats per minute. The best of this type are Inderal, Prinorm, propranolol, Presolol, atenolol.
Beta-blockers can be given alone, but are often combined with diuretics, vasodilators, and ACE inhibitors.
These drugs prevent the entry of calcium ions into muscle cells, namely those in the working muscles of the heart, the conduction system, and the blood vessels. This is crucial because the strength and contraction (contraction and relaxation) of the heart muscle depend on calcium.
They occupy an important place in the treatment of hypertension, and their main effect is:
* vasodilator (dilation of blood vessels)
* protective – reduces the possibility of heart attack
* antiarrhythmic – mainly in disorders of stimuli that occur in the atria and cause rapid transmission of stimuli to the ventricles
According to the recommendation of the World Health Organization (WHO), they are especially suitable for elderly patients if the effect of beta-blockers has no effect or diuretics cause side effects. In other words, they can work on their own, without a combination with other drugs – that means monotherapy (treatment with only one drug). This group includes verapamil or Isoptin, Nifelat, Nifecard, Cortiazem.
Side effects can be: redness of the face and body, the rush of blood to the head, headache, weakness, swelling of the lower legs and feet, nausea, constipation, lowering of blood pressure – sometimes significant and in a very short time.
Their main role is to prevent the activity of a substance, in fact, an enzyme, called angiotensin, which is produced in the kidneys, to narrow blood vessels and thus raise blood pressure.
In patients, there is no sudden drop in blood pressure or acceleration of heart rate because these drugs have a mild and moderate effect.
Diuretics enhance their effect and thus make a very suitable combination for the treatment of pressure. They do not reduce the tone of the sympathetic nervous system (as beta-blockers) and therefore do not cause impotence.
The side effects are not serious, except for a dry and persistent cough, but sometimes it is still necessary to stop the therapy because of that.
This group includes: prilazid, enalapril, katopil, zorcaptil, hemoquin, tritace. Sometimes their combination with diuretics is desirable.
This medicine is of medium strength, but stronger than diuretics and beta-blockers, so after a few days of taking it, it can lower the pressure by 20 to 40 mmHg.
Due to its short duration of action, the drug is taken 2 to 3 times a day.
Diuretics increase the effect of methyldopa, so they can be combined. It is thought to lower blood pressure by acting on certain parts of the brain.
This drug is usually used in combination with beta-blockers. In the case of coronary blood flow disorders, one should be careful because, if given alone, it can cause the heart to speed up.
Other side effects are headaches, tension in the stomach, but also a sharp drop in blood pressure when standing up (orthostatic hypotension).
This medicine is actually an alkaloid from the root of the Indian plant Rauvophy serpentine. More than 40 years ago, it was a great discovery, although the people of India had already been treated with this plant years before.
It seems reliable, light, and mild. Reserpine has a calming effect on the elderly and easily irritates patients with high blood pressure. It is often used in combination with diuretics.
Caution should be exercised at higher doses as it may cause depression.
These drugs affect the dilation of blood vessels by reducing peripheral resistance. They directly or indirectly reduce the effect of calcium on the tone of blood vessels, which results in, you guessed it? That’s right, lowering blood pressure.
Hydralazine and minoxidil (Loniten) belong to the group of those that act directly – they are not calcium antagonists.
Due to long-term blood pressure and changes in the heart muscle, rhythm disorders occur, and then this type of medication is used. Due to the speed and irregular heartbeat, there is not enough pumping of blood, which leads to heart fatigue. These are dangerous disorders where antiarrhythmics play an important role.
When heart failure occurs in patients with chronic hypertension, drugs from this group are given. This medicine strengthens the strength of the heart muscle and reduces the consumption of oxygen. The heart beats harder under his influence, but calmer.
It does not create a habit and does not lose its effect. It can be taken for years, of course under medical supervision so as not to exceed the dose.
And finally, the vaccine against hypertension.
At the congress of cardiologists in Dallas, the possibility of creating a vaccine that would stimulate the human body to produce antibodies against angiotensin 2 (a hormone that directly affects the lowering of arteries and thus leads to an increase in blood pressure) was presented. Of course, there is still no official vaccine against this type of disease.
The goal of treating hypertension is to keep blood pressure within normal limits for 24 hours, in order to prevent further damage to blood vessels and avoid the already mentioned complications on vital organs (heart, brain, kidneys). In order to achieve this, it is desirable to start treatment as early as possible, especially for patients who have high lower (diastolic) pressure.
The WHO Committee of Experts insists that treatment keep this number below 80 mmHg.
Discontinuation of treatment leads to a re-increase in blood pressure, and thus the result of previous treatment is annulled. The patient must not, on his own, reduce the dose of the drug, and especially we must not stop taking it. Such behavior is both wrong and dangerous.
Duration of treatment?
The answer to this question is, unfortunately, that it is lifelong. Medications only remove the symptoms, but not the cause of the disease. Therefore, any interruption of their intake in a chronic hypertensive person results in an immediate increase in blood pressure.
Despite the great success today in the treatment of this disease, it must be acknowledged that there is no ideal cure, nor a universal method of treatment.
The essence is in the individual needs and possibilities of the patient to apply hygienic-dietary measures, to take medication properly, and to change habits, which were risk factors.
In other words, it is necessary for the patient to get involved in the treatment and understand the essence of his disease, as well as to cooperate with the doctor.
It is the duty of the doctor to make a diagnosis, to prescribe medication, and to give advice regarding the way of life and diet, and the patient, of course, to adhere to all that.
In addition, the patient must be well informed about all this and not get excited if the blood pressure rises immediately, because he will have to deal with it for the rest of his life. Ambitions should be directed towards healthy habits.
It is known that certain occupations are a risk factor for the development of this disease (directors of large companies, bankers, as well as all professions related to finance, employees in direct contact with people, as well as all those professions that require great intellectual effort.
But there are also jobs which are performed in noise, crowds, where concentration and speed of reflexes are needed (bus drivers, taxi drivers), then factory workers where the work is accompanied by noise and monotony, because they work on the lane, as well as other specific professions that require special attention, for example, pilots.
Therefore, these people must pay special attention to the balance of blood pressure to avoid possible complications or accidents.
Laughter as therapy
The effect of laughter on blood pressure is very favorable because the muscles of the diaphragm, like other muscles, are in constant movement up and down, and in that way, they allow air to enter the lungs faster and to a greater extent, so the blood is supplied with oxygen.
In this way, the movements of these muscles achieve the same effect on the body as doing sports, jogging, aerobics, or other physical activities.
So, that’s it. We hope that this article has helped you find the right medicine that will best suit your needs and the health situation in which your heart is currently.
If you have any questions or feel that there is some other important medicine that we have not listed, feel free to leave a comment, it will mean a lot to us and we will be grateful for it.
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