Modern antihypertensive drugs are classified into 10 different groups according to their mechanism of action. After examining the patient's complaints and test results, the doctor prescribes one or more medications, which should never be changed independently. You can't recommend cardiovascular drugs to "a friend". The wrong choice can have serious consequences. All blood pressure lowering drugs are available with a prescription. In this article, we will examine their modern classification based on the active ingredients and the nature of the effect on the body.
People often ask pharmacies for new generation antihypertensive drugs without side effects. But this does not happen in practice. All effective drugs have side effects. You need to spend a lot of time choosing a class of anti-hypertensive drugs with your doctor. Test, adjust the dose, or replace it entirely if the drug is not suitable.
Classification of drugs used to treat high blood pressure (BP).
Diuretics or diuretics
Medicines that increase kidney function remove salts and excess water. This leads to a decrease in the volume of circulating blood and a decrease in vascular resistance - pressure drops. Not all diuretics are suitable for this purpose. The main requirements of such drugs are the mildness and duration of the diuretic effect and the ability to conserve potassium. Many drugs from this group are included in combination drugs for high blood pressure.
Thiazides are the most common. The medicine based on the substance indapamide is available in pure form and in complex form. Hydrochlorothiazide and chlorthalidone are commonly found in antihypertensive medications. Examples: chlorthalidone + atenolol, chlorthalidone + azilsartan substances. There are several options to choose from: the hydrochlorothiazide complex and various substances used to treat high blood pressure: quinapril, ramipril, candesartan, bisoprolol, losartan, valsartan. Indapamide is more common with lisinopril, amlodipine and perindopril.
If the doctor prescribes diuretics correctly, side effects practically do not occur. Potassium loss is not significant. Sometimes the 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 drug that contains two diuretics: hydrochlorothiazide and triamterene (potassium sparing). The indications for this drug are: edema syndrome, cirrhosis of the liver and high blood pressure.
Medicines that affect the activity of angiotensin-converting enzyme (ACE).
Many systems work simultaneously in our body to maintain normal blood pressure. One of these is the renin-angiotensin system. We will not describe the characteristics of its work, we will only say that the main active ingredient that increases blood pressure is angiotensin II oligopeptide. If a person experiences vascular imbalance, angiotensin should be inhibited. A large group of drugs has been developed for this purpose.
Generations of antihypertensive drugs affecting angiotensin II are constantly being updated. Many well-known and popular remedies are becoming obsolete and are being replaced by more modern and effective ones.
It starts working after about 1 hour and is active all day. It is considered a strong drug. Because of this, many people find it difficult to adjust the dose, which is impossible to do without a doctor. A special side effect is an excessive drop in blood pressure, which is dangerous. Sometimes the cardiologist is forced to completely stop a drug belonging to 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 frequent and less pronounced than when taking enalapril.
ACE blockers
The latest antihypertensive drugs without side effects such as cough, ACE blockers, work in a similar way but have a greater 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. Appropriate use of this drug reduces the risk of death in patients at high risk of cardiovascular pathologies. ACE blockers belonging to 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 strength of heart contractions. Adrenergic blockers are prescribed to those who do not respond to ACE inhibitors and to patients with heart disease. Several generations of drugs are distinguished here. The earliest drugs were based on atenolol and metoprolol. Currently, doctors prescribe bisoprolol fumarate drugs alone or in combination with a diuretic component.
This drug works primarily through the heart, reducing minute blood volume. It also affects blood vessels and renin activity. As a result, blood pressure and heart rate decrease. It is prescribed for chronic heart failure, to prevent angina attacks and to combat high blood pressure. Side effects can be dangerous: low heart rate, dizziness, heart conduction disorders.
Carvedilol has a combined adrenergic blocking effect. It is an alpha and beta adrenergic blocker. It belongs to the new generation and is considered a powerful drug. It reduces the pressure through the heart and peripheral blood vessels, dilates them. It is prescribed for the treatment of stable angina, chronic heart failure and high blood pressure.
Nebivolol is a third-generation beta-blocker. It has a better vasodilating effect and a higher safety profile.
Calcium channel blockers
Calcium normally maintains the contractility of the heart muscle and the tone of blood vessels. A class of drugs has been developed that has a limited effect on lowering blood pressure in high blood pressure.
Calcium channel blockers are considered powerful and are sometimes prescribed as an emergency treatment for very high blood pressure.
Preparations based on amlodipine besylateprescribed to treat high blood pressure and angina pectoris. Side effects are often hypotension, palpitations, swelling and deterioration of heart function. Medicines containing the active ingredient lercanidipine hydrochloride lower blood pressure primarily through the vascular system, so they have no side effects on the heart, or they are significantly less pronounced. Indications include only high blood pressure.
Imidazoline receptor agonists
This group of new antihypertensive drugs is called alpha 2 central adrenergic agonists.
As mentioned above, the vital support of vascular pressure is under the control of many systems in our body. One 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 takes place gradually.
Medicines based on moxonidine qualitatively lower blood pressure. But unlike others, this substance is contraindicated in acute and chronic heart failure, and these pathologies often accompany high blood pressure.
Adverse effects include dry mouth, diarrhea, drowsiness, headache, insomnia, and nervousness.
As we can see, there are no new antihypertensive drugs without side effects. The doctor selects the drug based on blood tests, ECG and tonometer readings. Before seeing a doctor, you should keep a diary of blood pressure values, where the pressure is recorded in the morning, afternoon and evening.
Adherence to a diet low in salt, animal fat and light carbohydrates, as well as regular sports activity, have a positive effect.
We can recommend nutritional supplements containing important elements to improve the functioning of the cardiovascular system. For example, selenium, magnesium, potassium. Many popular food supplements and vitamin complexes contain them.
A dietary supplement containing omega 3 supports the health of the vascular system and regulates blood pressure. A wide variety of medicines are available in pharmacies.