Modern blood pressure drugs are divided into 10 different groups according to the mechanism of action. The doctor, after studying the patient's complaints and the results of the tests, prescribes one or more drugs, which in no case should be changed independently. Cardiac and vascular drugs are not those that you can "recommend to a friend". The wrong choice can lead to serious consequences. All antihypertensive drugs are available by prescription. In this article, we will consider their modern classification based on active substances and natureof the effect on the body.
People often look in pharmacies for new generation drugs for blood without side effects. But this does not happen in practice. All effective drugs have their side effects. You will need to spend a lot of time choosing your group of hypertension drugs with your doctor. Test it, adjust the dose, or change it entirely if the drug is not suitable.
Classification of high blood pressure (BP) drugs
Diuretics or diuretics
Medicines that improve kidney function remove salts and excess water. This leads to a decrease in the volume of circulating blood and a decrease in vascular resistance - a drop in pressure. Not all diuretics are suitable for this purpose. The main requirement for such drugs is the ease and duration of the diuretic effect and the ability to preserve potassium. Many drugs from this group are included in combination drugs 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. Numerous options include a complex of hydrochlorothiazide with various agents for hypertension: with quinapril, ramipril, candesartan, bisoprolol, losartan, valsartan. Indapamide is more commonly found with lisinopril, amlodipine and perindopril.
When diuretics are prescribed correctly by a doctor, side effects are practically absent. Potassium losses are not significant. Sometimes the patient needs to change the drug due to 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.
Medicines affecting the activity of angiotensin-converting enzyme (ACE)
Several systems function 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 only say that the main active substance that increases blood pressure is the oligopeptide angiotensin II. When a person suffers a vascular imbalance, angiotensin must be inhibited. A large group of drugs has been developed for this purpose.
Generations of blood pressure drugs affecting angiotensin II are constantly being updated. Many well-known and popular drugs are already outdated and are being replaced by more modern and effective ones.
It begins to work after about 1 hour and is active throughout the day. It is considered a powerful medicine. For this reason, it is difficult for many to adjust the dosage, it is impossible to do this without a doctor. A particular side effect is excessive lowering of blood pressure, which is dangerous. Sometimes the cardiologist is forced to completely cancel the drug from 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 common and less pronounced than when taking enalapril.
ACE blockers
The newest blood pressure drugs without side effects like 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 reduce blood pressure after 3 hours, but the maximum effect occurs after 4-8 weeks of continuous use. The correct 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 drugs with the active ingredient bisoprolol fumarate, alone or in combination with a diuretic component.
This drug works primarily through the heart by reducing minute blood volume. It additionally 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 hypertension. 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 a new generation and is considered a powerful medicine. It reduces pressure through the heart and peripheral vessels by dilating them. It is prescribed for the treatment of stable angina pectoris, chronic heart failure and hypertension.
Nebivolol is a third-generation beta-blocker. It has a better vasodilator effect and a higher safety profile.
Calcium channel blockers
Calcium normally maintains myocardial contractility and vascular tone. A group of drugs has been developed that limit its effect in order to lower blood pressure in hypertension.
Calcium channel blockers are considered strong and are sometimes prescribed as an emergency treatment for very 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 reduce blood pressure primarily 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 medications are called alpha 2 central adrenergic agonists.
As mentioned above, the vital maintenance of vascular pressure 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 proceeds gradually.
Medicines based on moxonidine qualitatively reduce blood pressure. But unlike 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 drugs for blood without side effects. The choice of the drug will be made by the doctor based on the examination of blood tests, ECG and tonometer readings. Before visiting a 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 low in salt, animal fat and light carbohydrates, as well as regular exercise, have a positive effect.
To improve the work 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.
Omega 3 dietary supplement supports blood vessel health and regulates blood pressure. There is a wide variety of medicines in pharmacies.