Modern blood pressure drugs are divided into 10 different groups according to the mechanism of action. Studying the patient's complaints and test results, the doctor prescribes one or more drugs that should not be changed independently under any circumstances. Cardiovascular drugs are not drugs you can "recommend to a friend". The wrong choice can have dire consequences. Antihypertensive drugs are all available by prescription. In this article, we will consider their modern classification based on active substances and the nature of their effect on the body.
People often ask pharmacies for new generation blood pressure drugs without side effects. But in practice this does not happen. All effective drugs have side effects. You will need to spend a lot of time with your doctor to choose a group of drugs for hypertension. Test, adjust the dose, or change the drug entirely if it doesn't work.
Classification of drugs for high blood pressure (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 drugs is the mildness and duration of the diuretic effect, the ability to retain potassium. Many drugs from this group are included in combination drugs for hypertension.
The most common are thiazides. Medicine based on indapamide substance is available in pure form and complex form. Hydrochlorothiazide and chlorthalidone are commonly found in blood pressure medications. Examples: chlorthalidone + atenolol, chlorthalidone + azilsartan substances. Numerous options include a hydrochlorothiazide complex with various 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 a doctor, side effects are practically absent. 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 kind of diuretic is not enough. There is a drug that contains two diuretics: hydrochlorothiazide and triamterene (potassium sparing). Indications for this remedy are: 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 them is the renin-angiotensin system. We will not describe the specifics of its work, but we will only say that the main active substance that increases blood pressure is oligopeptide angiotensin II. When a person experiences a disturbance in vascular balance, angiotensin should be inhibited. A large group of drugs has been developed for this purpose.
Generations of blood pressure drugs that affect angiotensin II are constantly being updated. Many well-known and popular tools are already obsolete and replaced by more modern and effective ones.
It begins to act after about 1 hour and is active throughout the day. It is considered a powerful medicine. For this reason, many find it difficult to adjust the dosage, which cannot be done without a doctor. A particular side effect is an extreme drop in blood pressure, which is dangerous. Sometimes the cardiologist is forced to completely stop 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 less common and less pronounced when taking enalapril.
ACE blockers
The newest blood pressure medications without side effects like cough are ACE blockers, which act similarly 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. Correct use of this drug reduces the risk of death in patients with a high risk of cardiovascular pathologies. 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 heartbeats. 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 these were drugs based on atenolol and metoprolol. Now, doctors prescribe drugs with the active ingredient bisoprolol fumarate alone or in combination with a diuretic component.
This drug acts primarily through the heart, reducing minute blood volume. Additionally, it 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 fight hypertension. Side effects can be dangerous: low pulse, dizziness, heart failure.
Carvedilol has a combined adrenergic blockade. It is an alpha and beta adrenergic blocker. It belongs to the new generation and is considered a powerful medicine. It reduces the pressure through the heart and peripheral vessels, expands them. It is prescribed for the treatment of stable angina, 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 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 amlodipine besylate substanceprescribed for hypertension and angina pectoris. Side effects often include hypotension, palpitations, swelling, and heart failure. Medicines containing lercanidipine hydrochloride reduce blood pressure primarily through the vascular bed and therefore have no or significantly less side effects on the heart. Indications include only hypertension.
Imidazoline receptor agonists
This new class of blood pressure medications are called alpha 2 central adrenergic agonists.
As we mentioned above, the vital support of pressure in the vascular bed is under the control of many systems in our body. One of them is the vasomotor center in the brain. The substance moxonidine, a representative of the group, reduces the activity of this center and the pressure decreases, the process occurs gradually.
Medicines based on moxonidine qualitatively reduce blood pressure. However, 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 irritability.
As we can see, there are no new blood pressure drugs without side effects. The choice of medicine will be made by the doctor based on the study of blood tests, ECG and tonometer readings. Before going to the doctor, it is necessary to keep a diary of blood pressure values, in which 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 exercise, have a positive effect.
We can recommend food supplements with important elements to improve the functioning of the cardiovascular system. For example, selenium, magnesium, potassium. They are found in many popular dietary supplements and vitamin complexes.
Dietary supplementation with omega 3 supports vascular health and regulates blood pressure. There are many medicines in pharmacies.