Modern blood pressure medications are divided into 10 different groups according to the mechanism of action. The doctor, after studying the patient's complaints and test results, prescribes one or more medications, which should not be changed independently under any circumstances. Medicines for the heart and blood vessels are not those that you can "recommend to a friend". A wrong choice can lead to dire consequences. All antihypertensives are available by prescription. In this article, we will consider their modern classification based on active substances and the nature of their effects on the body.
People often look for new generation blood pressure drugs without side effects in pharmacies. But that doesn't happen in practice. All effective drugs have their side effects. You will need to spend a lot of time choosing a group of hypertension medications with your doctor. Test it, adjust the dose or replace it entirely if the drug is not suitable.
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 the volume of circulating blood and a decrease in vascular resistance - a drop in pressure. Not all diuretics are suitable for this purpose. The main requirement for such drugs is the mildness and duration of the diuretic effect, and the ability to preserve potassium. Many drugs from this group are included in combination drugs for hypertension.
The most common are thiazides. The drug based on the substance indapamide is available in pure and compound form. Hydrochlorothiazide and chlorthalidone are commonly found in blood pressure medications. Examples: substances chlorthalidone + atenolol, chlorthalidone + azilsartan. A number of options include a complex of hydrochlorothiazide with various substances for hypertension: with quinapril, ramipril, candesartan, bisoprolol, losartan, valsartan. Indapamide is more common with lisinopril, amlodipine and perindopril.
When diuretics are properly prescribed by a doctor, side effects practically do not exist. Potassium losses are not significant. Sometimes a patient has to change their medication 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). The indications for this drug are as follows: edema syndrome, liver cirrhosis and hypertension.
Medicines 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 characteristics of its work, but we will only say that the main active substance that increases blood pressure is the oligopeptide angiotensin II. When a person experiences a vascular imbalance, 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 continuously updated. Many well-known and popular drugs are already becoming obsolete and are being replaced by more modern and effective ones.
It starts working in about 1 hour and is active all day. It is considered a strong drug. For this reason, it is difficult for many to adjust the dose, it is impossible to do without a doctor. A special side effect is an excessive decrease in blood pressure, which is dangerous. Sometimes the cardiologist is forced to completely cancel 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 much less frequent and less pronounced than when taking enalapril.
ACE blockers
The newest 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 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 mortality in patients with a high risk of cardiovascular pathologies. ACE blockers from the sartan group are more expensive than ACE inhibitors because they work 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. Several generations of drugs differ here. The earliest of these 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 the cardiac output. It additionally affects blood vessels and renin activity. As a result, blood pressure and heart rate decrease. It is prescribed for chronic heart failure, for the prevention of angina pectoris attacks and for the fight against hypertension. Side effects can be dangerous: low pulse, dizziness, cardiac conduction disorders.
Carvedilol has a combined effect of blocking adrenergic acids. It is an alpha and beta adrenergic blocker. It belongs to the new generation and is considered a strong drug. It reduces the pressure through the heart and peripheral vessels, expanding them. It is prescribed for the treatment of stable angina pectoris, 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 that limit its action in order to lower blood pressure in hypertension.
Calcium channel blockers are considered strong 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 cardiac function. Medicines containing the substance lercanidipine hydrochloride lower blood pressure primarily through the vascular bed and therefore have no side effects on the heart or are significantly less pronounced. Among the indications is only hypertension.
Imidazoline receptor agonists
This group of new blood pressure medications are called alpha 2 central adrenergic agonists.
As we have already mentioned, the vital pressure support 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 representative of the group, the substance moxonidine, reduces the activity of this center and the pressure decreases, the process takes place gradually.
Medicines based on moxonidine qualitatively lower 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 drugs without side effects. The selection of the drug will be made by the doctor based on the study of blood tests, EKG and tonometer readings. Before visiting the doctor, it is necessary to keep a diary of blood pressure values, where the pressure will be recorded in the morning, afternoon and evening.
Adherence to a diet with little salt, animal fat and light carbohydrates, as well as regular sports activities, has a positive effect.
To improve the functioning of the cardiovascular system, we can recommend nutritional supplements with important elements. For example, selenium, magnesium, potassium. Many popular food supplements and vitamin complexes contain them.
A dietary supplement with omega 3 supports the health of blood vessels and regulates blood pressure. There is a wide selection of medicines in pharmacies.