Modern blood pressure drugs are divided into 10 different groups based on 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 on their own. Medicines for the heart and vascular vessels are not those that you can "recommend to a friend. "A wrong choice can lead to disastrous consequences. Antihypertensive drugs are all available by prescription. In this article we will consider their modern classification according to the active ingredients and the nature of the effect on the body.
People often ask pharmacies for new generation blood pressure drugs 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 hypertension drug group with your doctor. Test it, adjust the dose or replace it altogether if the medicine is not suitable.
Classification of drugs for high blood pressure (BP)
Diuretics or diuretics
Drugs that improve kidney function remove excess salts and 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 drugs is the gentleness and duration of the diuretic effect and the ability to store potassium. Many drugs from this group are included in combined 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 several substances for hypertension: with quinapril, ramipril, candesartan, bisoprolol, losartan, valsartan. Indapamide is more common with lisinopril, amlodipine, and perindopril.
When diuretics are prescribed correctly by your doctor, side effects are practically non-existent. Potassium losses are not significant. Sometimes a 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). Indications for this remedy are as follows: edema syndrome, liver cirrhosis and hypertension.
Drugs that affect the activity of angiotensin-converting enzyme (ACE)
Several systems work simultaneously in our body to maintain normal blood pressure. One of these is the renin-angiotensin system. We will not describe the features of its work, but will only say that the main active ingredient that increases blood pressure is the oligopeptide angiotensin II. When a person experiences a disruption of vascular balance, angiotensin should be inhibited. A large group of drugs has been developed for this purpose.
Generations of blood pressure drugs that act on angiotensin II are continually updated. Many well-known and popular remedies are already becoming obsolete and are being replaced by more modern and effective ones.
It starts working in about 1 hour and is active throughout the day. It is considered a powerful drug. For this reason, many find it difficult to adjust the dosage, it is impossible to do it without the doctor. A particular side effect is an excessive drop in blood pressure, which is dangerous. Sometimes the cardiologist is forced to completely discontinue a medicine 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
Newer blood pressure medications 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 new.
Sartans reduce blood pressure after 3 hours, but the maximum effect is achieved after 4-8 weeks of continuous use. Correct use of this drug reduces the risk of mortality in patients at high risk of cardiovascular disease. 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 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. Different generations of drugs are distinguished here. The first were drugs based on the substances atenolol and metoprolol. Now doctors prescribe drugs with the active ingredient bisoprolol fumarate, 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. 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 exerts 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. It reduces pressure across 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 its effect to lower blood pressure in hypertension.
Calcium channel blockers are considered powerful 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 deterioration of heart function. Medicines containing the substance lercanidipine hydrochloride reduce blood pressure mainly via the vascular bed and therefore have no or significantly less pronounced side effects on the heart. Among the indications there is only hypertension.
Imidazoline receptor agonists
This group of new blood pressure medications is called alpha 2 central adrenergic agonists.
As mentioned above, life-sustaining pressure in the vascular bed is under the control of many systems of our body. One of these 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.
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.
Side 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 drug will be made by the doctor based on the study of blood tests, ECG and tonometer readings. Before visiting a doctor, you need to keep a diary of blood pressure values, where the pressure will be recorded in the morning, afternoon and evening.
A positive effect is compliance with a diet low in salt, animal fats and light carbohydrates, as well as regular sporting activity.
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 dietary supplements and vitamin complexes.
The dietary supplement with omega 3 supports vascular health and regulates blood pressure. There is a wide variety of medications available in pharmacies.