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 medications, which in no case should be changed independently. Cardiac and vascular medications are not ones you can "recommend to a friend. "A wrong choice can lead to dire consequences. Antihypertensive medications are all available with a 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 ask pharmacies for new generation blood pressure medications without side effects. But this doesn't happen in practice. All effective medicines have their side effects. You will have to spend a lot of time choosing your high blood pressure medication group with your doctor. Test, adjust the dose, or replace completely if the medication is not suitable.
Classification of medications for hypertension (BP)
Diuretics or diuretics
Medicines that improve kidney function remove salts and excess water. This leads to a decrease in circulating blood volume and a decrease in vascular resistance - pressure drops. Not all diuretics are suitable for this purpose. The main requirement for such medicines is the mildness and duration of the diuretic effect and the ability to conserve potassium. Many medicines from this group are included in combination medicines for hypertension.
The most common are thiazides. The medicine based on the substance indapamide is available in pure and 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 different substances for hypertension: with quinapril, ramipril, candesartan, bisoprolol, losartan, valsartan. Indapamide is most common with lisinopril, amlodipine, and perindopril.
When diuretics are prescribed correctly by a doctor, side effects are practically non-existent. Potassium losses are not significant. Sometimes a patient needs to change medications due to an allergic reaction. In some cases, your doctor may prescribe potassium supplements.
It turns out that one type of diuretic is not enough. There is a medicine that includes two diuretics: hydrochlorothiazide and triamterene (potassium-sparing). The indications for this remedy are as follows: edematous syndrome, liver cirrhosis and hypertension.
Medicines 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 operation, but will only say that the main active substance that increases blood pressure is the oligopeptide angiotensin II. When a person experiences a disturbance in vascular balance, angiotensin must be inhibited. A large group of medicines has been developed for this purpose.
Generations of blood pressure medications that affect angiotensin II are continually updated. Many well-known and popular remedies are already becoming outdated and being replaced by more modern and effective ones.
It starts to act in approximately 1 hour and remains active throughout the day. It is considered a strong drug. Therefore, many have difficulty adjusting the dosage; it is impossible to do this without a doctor. A specific side effect is an excessive decrease in blood pressure, which is dangerous. Sometimes the cardiologist is forced to completely discontinue a medication from this group. But for severe headache symptoms, perindopril is the 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 medications without side effects like coughing 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 new.
Sartans reduce blood pressure after 3 hours, but the maximum effect occurs after 4-8 weeks of continuous use. Proper use of this medication 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 medications works by reducing the activity of adrenaline, which increases blood pressure and the frequency and strength 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 first of these were medicines based on the substances atenolol and metoprolol. Doctors now prescribe medications with the active ingredient bisoprolol fumarate, alone or in combination with a diuretic component.
This medicine works mainly through the heart, reducing minute blood volume. Furthermore, it 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 disturbances.
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 drug. Reduces pressure in the heart and peripheral vessels, dilating them. Prescribed for the treatment of stable angina, chronic heart failure and hypertension.
Nebivolol is a third generation beta blocker. It has a better vasodilatory 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 their effect to reduce blood pressure in hypertension.
Calcium channel blockers are considered strong and are sometimes prescribed as 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 deterioration in heart function. Medicines containing the substance lercanidipine hydrochloride reduce blood pressure mainly through the vascular bed and therefore have no or significantly less pronounced side effects on the heart. Among the indications is only hypertension.
Imidazoline receptor agonists
This group of new blood pressure medications is called alpha 2 central adrenergic agonists.
As we mentioned above, life support pressure in the vascular bed is under the control of many systems in our body. One of them 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 occurs gradually.
Moxonidine-based drugs qualitatively reduce blood pressure. But, unlike others, this substance is contraindicated in acute and chronic heart failure, and these pathologies often accompany hypertension.
Undesirable effects include dry mouth, diarrhea, drowsiness, headache, insomnia and nervousness.
As we can see, there are no new blood pressure medications 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 consulting a doctor, it is necessary to keep a diary of blood pressure values, where the pressure will be recorded in the morning, afternoon and evening.
Adhering to a diet low in salt, animal fats and light carbohydrates, as well as regular sports, have a positive effect.
To improve the functioning of the cardiovascular system, we can recommend nutritional supplements with important elements. For example, selenium, magnesium, potassium. They are contained in many popular dietary supplements and vitamin complexes.
Dietary supplement with omega 3 supports vascular health and regulates blood pressure. There is a wide variety of medicines available in pharmacies.