Medicine for High Blood Pressure

WHAT ARE THE MOST POPULAR MEDICATIONS FOR PRESSURE? In terms of dollar sales, there are 5 leading drugs for high blood pressure.

Angiotensin II receptor blocker valsartan (Diovan) at the forefront of drugs for high blood pressure.
hypertension drugs,
the beta-blocker metoprolol,
generic combination of valsartan and HCTZ,
olmesartan (Benicar), and
olmesartan and HCTZ (Benicar HCT).

In terms of prescriptions written, here are the top 4 drugs for high blood pressure,

The ACE inhibitor lisinopril (Prinivil, Zestril) is at the top of the list,
afterwards, amlodipine besylate (Norvasc),
calcium channel blocker, and
generic hydrochlorothiazide (HCTZ).

WHAT IS THE BEST CURE FOR HIGH BLOOD PRESSURE? The choice of the "best" hypertension drug depends on several factors, including the patient's overall health, age, ethnicity and whether he or she has any comorbid medical problems or drug sensitivities. For example, in a patient with hypertension and asthma, it may not be advisable to prescribe a beta-blocker, as these drugs can worsen this respiratory condition. Similarly, in patients prone to constipation (for example, the elderly), it is best to avoid certain calcium channel blockers - along with diuretics - because both classes of drugs can inhibit normal bowel function. African-American patients respond better to some antihypertensive drugs than others. Some groups of patients require a specific class of hypertension drugs. These include: Pregnant women The drug of choice for pregnant women with hypertension is one of the oldest hypertension drugs on the market. Methyldopa, which works to lower blood pressure through the central nervous system, has the lowest risk of harm to the mother and the developing fetus. Other possible safe options include labetalol, beta-blockers and diuretics. Two classes of drugs that should never be used during pregnancy are ACE inhibitors and angiotensin II receptor blockers. African-Americans Hypertension in African-Americans occurs earlier and has a more severe course. In addition, some drugs that lower blood pressure in other ethnic groups may have limited effect in African-Americans. Thiazide diuretics (such as HCTZ) or calcium channel blockers are recommended first, along with the possibility of adding a second drug from the ACE inhibitor or angiotensin II receptor blocker class. Elderly patients As we age, the risk of systolic hypertension increases, which can be exacerbated by severe atherosclerosis. According to one study, the diuretic chlortalidone (Hygroton) provided significant benefit in older patients with systolic hypertension. Along with a diuretic, some calcium channel blockers, ACE inhibitors and angiotensin II receptor blockers may also be good choices. However, beta-blockers may not be as effective in treating hypertension in people over 60, although they may be a good choice for coexisting heart disease. In elderly patients, it may be more beneficial to administer two hypertension drugs at a low dose than one at a higher dose. LIST OF REMEDIES FOR HIGH BLOOD PRESSURE There are several classes of drugs for hypertension. Each lowers blood pressure in a different way.

Diuretics
Beta-blockers
ACE inhibitors
Angiotensin II receptor blockers
Calcium channel blockers
Alpha-blockers
Alpha-2 receptor agonist
Agonists of the center
Operipheral adrenergic inhibitors
Vasodilators

DIURETICS Diuretics increase urination, which reduces the amount of sodium and fluid in the body. This can help lower blood pressure because it reduces blood volume. Mild hypertension can sometimes be treated with diuretics alone, although they are more commonly used in combination with other medications for high blood pressure. Examples of diuretics include:

Bumetanide (Bumex)
Chlorthalidone (Hygroton)
Chlorothiazide (Diuril)
Etacrine (Edecrin)
Furosemide (Lasix)
Hydrochlorothiazide HCTZ (Esidrix, Hydrodiuril, Microzide)
Indapamide (Lozol)
Methylthiazide (Enduron)
Metolazone (Mykroz, Zaroxolyn)
Torsemide (Demadex)

One of the side effects of diuretics is the loss of potassium, which is taken out of the body in the urine along with sodium. Potassium is needed for proper muscle movement and a deficiency of this mineral can cause fatigue, weakness, leg cramps and even heart problems. Therefore, patients taking traditional diuretics are often advised to take them with potassium-rich foods, such as orange juice or bananas, or are prescribed a potassium supplement. Some diuretics are designed to address potassium loss. These blood pressure drugs are known as "potassium-sparing" diuretics. These include amiloride (Midamor), spironolactone (Aldactone) and triamterene (Dyrenium). Finally, there are combination diuretics that contain a potassium-sparing agent and a traditional diuretic. These include amiloride hydrochloride and HCTZ hydrochlorothiazide (Moduretic), spironolactone and HCTZ (Aldactazide), and triamterene and HCTZ (Dyazide, Maxzide). BETA-BLOCKERS Beta-blockers lower blood pressure by acting directly on the heart. These medications for high blood pressure reduce the heart rate and pumping force, and also reduce blood volume. Beta-blockers include:

Acebutolol (Sectral)
Atenolol (Tenormin)
Bisoprolol fumarate (Zebeta)
Carvedilol (Coreg) -- a combination alpha/beta blocker
Esmolol (Brevibloc)
Labetalol (Trandate, Normodyne) -- a combined alpha/beta receptor blocking drug
Metoprolol tartrate (Lopressor) and metoprolol succinate (Toprol-XL)
Nadolol (Corgard)
Nebivolol (Bystolic)
Penbutolol sulfate (Levatol)
Propranolol (Inderal)
Sotalol (Betapace)
HCTZ and bisoprolol (Ziac) is a beta-blocker plus diuretic.

INHIBITORS ACE Angiotensin is a hormone in the body that causes blood vessels to constrict. Angiotensin-converting enzyme (ACE) inhibitors reduce angiotensin production and, in turn, this helps lower blood pressure. Examples of ACE inhibitors include:

Benazepril hydrochloride (Lotensin)
Kaptopril (Capoten)
Maleinian enalapril (Vasotec)
Fosinopril sodium (Monopril)
Lisinopril (Prinivil, Zestril)
Moexipril (Univasc)
Perindopril (Aceon)
Quinapril hydrochloride (Accupril)
Ramipryl (Altace)
Trandolapril (Mavik)

ANGIOTENSIN II RECEPTOR BLOCKERS The hormone angiotensin constricts blood vessels, but to do its job it needs a place to bind. This is where angiotensin II receptor blockers step in. They prevent angiotensin from binding to receptors in blood vessels, which helps lower blood pressure. Angiotensin II receptor blockers include:

Azilsartan (Edarbi)
Kandesartan (Atacand)
Mezylan eprosartanu (Teveten)
Irbesartan (Avapro)
Losartan Potassium (Cozaar)
Olmesartan (Benicar)
Telmisartan (Micardis)
Walsartan (Diovan)

LAPPER CANAL BLOCKERS Calcium increases the strength and power of contractions in the heart and blood vessels. Blocking its entry into smooth muscle tissue reduces this effect. Calcium channel blockers lower blood pressure by relaxing blood vessels and reducing heart rate. Examples of calcium channel blockers include:

Amlodipine bisilate (Norvasc, Lotrel)
Clavidipine (Cleviprex)
Diltiazem hydrochloride (Cardizem CD, Cardizem SR, Dilacor XR, Tiazac)
Felodipine (Plendil)
Izradipine (DynaCirc, DynaCirc CR)
Nicardipine (Cardene SR)
Nifedipine (Adalat CC, Procardia XL)
Nimodipine (Nimotop, Nymalize)
Nisoldipina (Sular)
Verapamil hydrochloride (Calan SR, Isoptin SR, Verelan, Covera HS).

ALFA-BLOCKERS Alpha-blockers cause blood vessels to dilate, thus lowering blood pressure. These drugs are also used to treat prostate enlargement in men. Alpha receptor blocking drugs include

doxazosin (Cardura) mesylate,
prazosin hydrochloride (Minipress), and
terazosin hydrochloride (Hytrin).

AGONIST RECEPTOR ALPHA-2 Methyldopa, formerly known by the trade name Aldomet, is one of the oldest blood pressure drugs still in use.

It was first introduced more than 50 years ago.
Methyldopa acts in the central nervous system to lower blood pressure.
Although its overall use has declined over the years, methyldopa is considered the first-line treatment for high blood pressure that develops during pregnancy.

CENTRAL AGENTS Some hypertension drugs act in the central nervous system rather than directly on the cardiovascular system. Central agonists therefore tend to cause drowsiness. Drugs in this class include.

clonidine hydrochloride (Catapres) and
guanfacine hydrochloride (Tenex).

Circular ADRENERGY INHIBITORS There was a time when the list of drugs for hypertension was very short indeed. In the 1950s, reserpine was one of the few preparations on the market that treated hypertension. It is rarely used due to its numerous side effects and drug interactions. Peripheral adrenergic inhibitors work in the brain to block the signals that tell blood vessels to constrict. They are most often used when other drugs for high blood pressure do not solve the problem. Peripheral adrenergic inhibitors include

Guanadrel (Hylorel),
guanethidine monosulfate (Ismelin), and
reserpine (Serpasil).

VASODILATORS Vasodilators relax the muscles of the arterial walls, resulting in a drop in blood pressure. These drugs are usually not used alone -- and in the case of Minoxidil (Loniten) -- used only in severe hypertension. Vasodilators include the following

Hydralazine (Apresoline) i
minoxidil (Loniten).

WHAT ARE THE EFFECTIVE CONSEQUENCES OF ADHD? Different classes of blood pressure drugs have different side effects. Diuretics

Diuretics can lead to increased potassium loss, known as hypokalemia, which in turn can affect muscle function-including heart muscle.
There is also an increased risk of gout with diuretics -- as well as the possibility of weakness, thirst, dehydration and increased urination.
Changes in blood sugar levels are also possible.
Cutaneous reactions, some severe, are possible with thiazide diuretics (such as hydrochlorothiazide).
Potassium-sparing diuretics such as spironolactone (Aldactone) can cause breast enlargement in men.

Beta-blockers Beta blockers cause the heart to slow down and therefore some of their side effects can be attributed to this mechanism of action.

Dizziness, weakness, fatigue and fainting are possible.
Beta-blockers also affect the respiratory system, so other side effects include shortness of breath, difficulty breathing and chest pain.
Beta-blockers should not be discontinued abruptly, as this can cause heart attack or sudden death.

Inhibitory ACE

The most common side effect of ACE inhibitors is also unusual - a dry cough. It usually subsides with continued use of the drug, but it can last for weeks.
ACE inhibitors can lower blood pressure too much, causing hypotension, which in turn can lead to headache, dizziness, fainting and decreased kidney function.

Angiotensin II receptor blockers

The most common side effect of angiotensin receptor blockers (ARBs) is increased blood potassium levels, known as hyperkalemia.
Dizziness and fatigue are also common.
Upper respiratory tract infections have also been reported -- along with gastrointestinal problems such as upset stomach and diarrhea.

Calcium channel blockers Up to one-third of patients may experience the following side effects associated with calcium channel blockers:

Oedema of ankles and other extremities,
rumpets, and
Dizziness
Other common side effects include heartburn and nausea.

Alpha-blockers A common, temporary but worrisome initial side effect of alpha-blockers is

postural hypotension
It is a sudden drop in blood pressure when standing up.
It can be severe enough to cause dizziness or even fainting.
Also, alpha-blockers can cause increased heart rate, headache, nausea and weakness.

Metyldopa Methyldopa is generally well tolerated, but some patients may experience

dizziness,
insomnia,
weakening,
headache i
Dryness in the mouth

Agonists of the center

Up to 40% of patients taking clonidine (Catapres) will experience dry mouth, and about a third will experience drowsiness, headache.
Other common side effects include constipation, dizziness and local skin reactions when using the Catapres-TTS skin patch.
Stosowanie rezerpiny jest związane z możliwymi działaniami niepożądanymi, w tym koszmarami, dusznym nosem, depresją i niemożnością zasypiania. Możliwe są również biegunka i zgaga.
Guanadrel and guanethidine can cause diarrhea and other gastrointestinal problems - as well as dizziness and drowsiness.
Vasodilators
Taking minoxidil can cause excessive body hair growth, as well as weight gain and dizziness.
Hydralazine is associated with headaches, palpitations, swelling around the eyes, and joint pain.

Wazodylatatory

Taking minoxidil can cause excessive body hair growth, as well as weight gain and dizziness.
Hydralazine is associated with headaches, palpitations, swelling around the eyes, and joint pain.

CAN I TAKE PREGNANCY MEDICATION SAFELY DURING PREGNANCY? Some hypertension medications should not be used during pregnancy because they can harm the mother and the developing fetus. These medications include

inhibitory ACE i
Angiotensin II receptor blockers
Reserpine can also be harmful during pregnancy and should only be used if there are no other alternatives.
Safe drugs to use include methyldopa and potentially some diuretics and beta-blockers, including labetalol.

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