Modern blood pressure medications are divided into 10 different groups based on their mechanism of action. The doctor, after examining the patient's complaints and test results, prescribes one or more medications, which in no case should be changed independently. Cardiovascular drugs are not drugs that can be "recommended to a friend". A wrong choice can have dire consequences. All antihypertensive drugs require a prescription. In this article we will consider their modern classification based on the active ingredients and the type of effect on the body.
People often ask in pharmacies for new generation blood pressure medications without side effects. However, this does not happen in practice. All effective medications have their side effects. You will need to spend a lot of time working with your doctor to select your high blood pressure medication group. Test it, adjust the dose, or replace it entirely if the medication is not suitable.
Classification of medications for high blood pressure (BP)
Diuretics or diuretics
Drugs 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 drop. Not all diuretics are suitable for this. The main requirement for such drugs is the mildness and duration of the diuretic effect, as well as the ability to save potassium. Many drugs from this group are included in combination medications for high blood pressure.
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. The numerous options include a complex of hydrochlorothiazide with various substances for high blood pressure: with quinapril, ramipril, candesartan, bisoprolol, losartan, valsartan. Indapamide is more common with lisinopril, amlodipine and perindopril.
If diuretics are prescribed correctly by a doctor, side effects are practically impossible. 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 happens that one type of diuretic is not enough. There is a drug that contains two diuretics: hydrochlorothiazide and triamterene (potassium-sparing). The indications for this remedy are: edema syndrome, liver cirrhosis and hypertension.
Medicines that affect the activity of the angiotensin converting enzyme (ACE).
In our body, several systems work simultaneously to maintain normal blood pressure. One of these is the renin-angiotensin system. We will not describe the features of its action, but only say that the main active ingredient that increases blood pressure is the oligopeptide angiotensin II. If a person experiences a vascular imbalance disorder, angiotensin should be inhibited. A large group of drugs has been developed for this purpose.
Generations of blood pressure medications that affect angiotensin II are continually being updated. Many well-known and popular remedies are already outdated and are being replaced by more modern and effective ones.
The effects begin after about an hour and are active throughout the day. It is considered a powerful medicine. For this reason, many people find it difficult to adjust the dosage; this is not possible without a doctor. A particular side effect is an excessive drop in blood pressure, which is dangerous. Sometimes the cardiologist is forced to completely stop taking a drug from this group. But for severe headache symptoms, perindopril is an ideal choice, especially when combined with indapamide. Coughing and shortness of breath occur significantly less frequently when taking perindopril and are less severe than when taking enalapril.
ACE blockers
The newest medications for blood pressure 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. Valsartane is no longer considered new.
Sartans lower blood pressure after 3 hours, but the maximum effect occurs after 4-8 weeks of continuous use. Proper use of this drug reduces the risk of death in patients at high risk of cardiovascular disease. ACE blockers from the Sartan group are more expensive than ACE inhibitors because they have a more selective effect 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 patients with heart disease. Several generations of medication are distinguished. The earliest of these were medications 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 drug works primarily through the heart, reducing the tiny volume of blood. Additionally affects blood vessels and renin activity. This causes blood pressure and heart rate to drop. 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 has a combined adrenergic blocking effect. It is an alpha and beta blocker. Belongs to a new generation and is considered a powerful drug. Reduces pressure in the heart and peripheral vessels and dilates them. Prescribed for the treatment of stable angina, chronic heart failure and hypertension.
Nebivolol is a third generation beta blocker. It has a better vasodilating 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 action to reduce 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 high blood pressure and angina pectoris. Side effects often include hypotension, palpitations, swelling, and worsening of heart function. Medicines that contain the substance lercanidipine hydrochloride lower blood pressure primarily via the vascular bed and therefore have no or significantly weaker side effects on the heart. The only indications include high blood pressure.
Imidazoline receptor agonists
This group of new blood pressure medications is called alpha-2 central adrenergic agonists.
As mentioned above, the vital maintenance of pressure in the vascular bed is controlled by many systems in 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 lower blood pressure. But unlike others, this substance is contraindicated in acute and chronic heart failure, and these pathologies are often accompanied by hypertension.
Adverse 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 is made by the doctor based on blood tests, ECG and tonometer readings. Before seeing a doctor, you need to keep a blood pressure diary, in which pressure is recorded in the morning, afternoon and evening.
Adhering to a diet low in salt, animal fat and light carbohydrates as well as regular sporting activities have a positive effect.
To improve the functioning of the cardiovascular system, we can recommend nutritional supplements containing important elements. For example, selenium, magnesium, potassium. They are contained in many popular dietary supplements and vitamin complexes.
Omega 3 supplements support vascular health and regulate blood pressure. There is a large selection of medications in pharmacies.