![](https://www.emergency-live.com/wp-content/uploads/2023/01/monitoraggio-pressorio-delle-ventiquattro-ore-1200-900-1.jpg)
Blood pressure medication: an overview of antihypertensive agents
Blood pressure problems, whether pathological or caused by circumstantial situations (pregnancy, for example) are addressed by antihypertensive drugs
Antihypertensives are a class of drugs used in the control of elevated (blood) pressure (hypertension), which is a major cardiovascular risk factor.
Based on their mechanism of action, antihypertensives can be divided into four broad categories:
- Drugs acting on the sodium-water balance (diuretics)
- Drugs acting on the sympathetic nervous system
- Drugs that reduce peripheral resistance (vasodilators)
- Drugs active on the renin-angiotensin-aldosterone system
High blood pressure? When to use antihypertensive drugs
Antihypertensives as mentioned are drugs that basically lower blood pressure.
Some of them work by widening blood vessels (vasodilators), others remove excess fluid from the blood or block natural hormones produced by the body that increase blood pressure.
Of course, the doctor takes many factors into account, both in prescription and dosage, such as the age, race, gender of the patient.
Sometimes he or she may find it useful to prescribe a main one to which an additional one or two may be added.
In general, these drugs are taken in pill form, but in the case of hospitalisation it is not uncommon to switch to IV (intravenous) administration.
What do blood pressure medications treat?
Blood pressure medication treats high blood pressure, or hypertension, with the aim of keeping the heart strong and preventing heart failure, heart attack, kidney failure or stroke.
Hypertension makes your heart’s work harder and more demanding.
Lowering your blood pressure makes it easier for your heart to keep pumping blood to essential organs and cells 24 hours a day.
Hypertension, which antihypertensive agents are chosen?
The doctor assesses a number of favourable factors, as well as possible side effects.
The best known and most popular are:
- Thiazide
- ACE inhibitors.
- Calcium channel blockers.
Types of blood pressure medication
A) Adrenergic blockers (including alpha, beta, alpha-beta and peripheral acting blockers)
What they do: they prevent your body from increasing blood pressure in reaction to stress.
Side effects of selected blood pressure medications:
- Fainting.
- Dizziness.
- Fatigue.
- Low heart rate.
B) Angiotensin-converting enzyme (ACE) inhibitors
What they do: they prevent your body from producing angiotensin II (a blood vessel constrictor).
Side effects of selected blood pressure medications:
- Coughing.
- High potassium.
- Dizziness.
- Angioedema (swelling of the face and neck); if you have this dangerous reaction, you should not take an ACE inhibitor drug again.
C) Angiotensin II receptor blockers (ARBs)
What they do: they prevent angiotensin II from constricting the blood vessels.
Side effects of selected blood pressure medications:
- High potassium.
- Dizziness.
D) Calcium channel blockers (including dihydropyridines and non-dihydropyridines)
What they do: They keep calcium out of the blood vessels, which allows the blood vessel muscle to relax and loosen.
Side effects of selected blood pressure medications:
- Headaches.
- Dizziness.
- Fast or slow heart rate.
- Swelling of the lower leg.
E) Centrally acting alpha-agonists
What they do: they prevent the nervous system from responding to stress.
Side effects of selected blood pressure medications:
- Tiredness.
- Dry mouth.
- Slow heart rate.
F) Direct vasodilators
What they do: They make the blood vessels more open.
Side effects of selected blood pressure drugs:
- Fast heart rate.
- Headache.
- Swelling of the lower leg.
G) Diuretics (including potassium-sparing, loop, and thiazide diuretics)
What they do: they help your blood vessels widen and cause your kidneys to move more fluid and salt into your pee.
Side effects of selected blood pressure medications:
- High or low levels of magnesium or potassium.
- Stomach upset.
- High levels of uric acid.
- Dizziness.
What are the risks or complications of antihypertensive drugs?
Some patients experience a sudden drop in blood pressure when they stand up (orthostatic hypotension).
Antihypertensive drugs can make the situation worse and the elderly may feel dizzy and fall, sometimes injuring themselves.
Some antihypertensive drugs alter electrolyte levels as you lose extra fluid in the urine.
Too high or too low levels of potassium can cause dangerous heart rhythms.
Will blood pressure medication lower my heart rate?
Yes, some medicines for high blood pressure, such as beta-blockers, can lower the heart rate.
Which blood pressure medications are safe during pregnancy?
You can take methyldopa, labetalol or nifedipine during pregnancy, but consult your doctor for their recommendation.
Many other antihypertensives are not safe for your developing fetus, so be sure to inform your doctor when you plan to become pregnant.
What is a first-choice medication for hypertension?
First-line (first-choice) options include these names of blood pressure drugs: thiazide diuretics, calcium channel blockers and – for people with kidney disease and heart failure – angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs).
Beta-blockers may also be first-line choices if the patient has a history of heart disease.
Bibliographic references
- American Heart Association. Types of Blood Pressure Medications. (https://www.heart.org/en/health-topics/high-blood-pressure/changes-you-can-make-to-manage-high-blood-pressure/types-of-blood-pressure-medications) Accessed 4/29/2022.
- Antihypertensive Drugs. In: Stringer JL. Basic Concepts in Pharmacology: What You Need to Know for Each Drug Class, 6e. McGraw Hill; 2022. Accessed 4/29/2022.
- Butt DA, Harvey PJ. Benefits and risks of antihypertensive medications in the elderly. (https://pubmed.ncbi.nlm.nih.gov/26497967/) J Intern Med. 2015;278(6):599-626. Accessed 4/29/2022.
- CDC. Hypertension. (https://www.cdc.gov/nchs/fastats/hypertension.htm) Accessed 4/29/2022.
- Eschenhagen T. Treatment of Hypertension. In: Brunton LL, Hilal-Dandan R, Knollmann BC. Goodman & Gilman’s: The Pharmacological Basis of Therapeutics, 13e. McGraw Hill; 2017. Accessed 4/29/2022.
- Khalil H, Zeltser R. Antihypertensive Medications. (https://www.ncbi.nlm.nih.gov/books/NBK554579/) StatPearls Publishing; 2021. Accessed 4/29/2022.
- McQueen CE. Herbal and Nonherbal Dietary Supplements. In: Sutton S. McGraw Hill’s NAPLEX® Review Guide, 4e. McGraw Hill; 2020. Accessed 4/29/2022.
- Merck Manual Consumer Version. High Blood Pressure. (https://www.merckmanuals.com/home/heart-and-blood-vessel-disorders/high-blood-pressure/high-blood-pressure?query=antihypertensives) Accessed 4/29/2022.
- Merck Manual Consumer Version. Drug Treatment of High Blood Pressure. (https://www.merckmanuals.com/home/heart-and-blood-vessel-disorders/high-blood-pressure/drug-treatment-of-high-blood-pressure) Accessed 4/29/2022.
- National Heart, Lung, and Blood Institute. High Blood Pressure. (https://www.nhlbi.nih.gov/health-topics/high-blood-pressure) Accessed 4/29/2022.
Read Also
Emergency Live Even More…Live: Download The New Free App Of Your Newspaper For IOS And Android
High Blood Pressure, When To Seek Emergency Care
The Decalogue For Measuring Blood Pressure: General Indications And Normal Values
Elevated Blood Pressure Can Cause Cardiac Damage During Adolescence
Holter Blood Pressure: Everything You Need To Know About This Test
Blood Pressure Emergencies: Some Information For Citizens
Alpha-Blockers, Drugs For The Treatment Of High Blood Pressure
Twenty-Four-Hour Ambulatory Blood Pressure Monitoring: What Does It Consist Of?
Full Dynamic Electrocardiogram According To Holter: What Is It?
Hypertension: Symptoms, Risk Factors And Prevention
Organ Complications Of Hypertension
How To Conduct Antihypertensive Treatment? An Overview Of Drugs
Blood Pressure: What It Is And How To Measure It
Aetiological Classification Of Hypertension
Classification Of Hypertension According To Organ Damage
Essential Hypertension: Pharmacological Associations In Antihypertensive Therapy
Treatment Of High Blood Pressure
Heart Failure: Causes, Symptoms And Treatment
The Thousand Faces Of Vascular Disease
Blood Pressure: When Is It High And When Is It Normal?
First Aid, When Is It An Emergency? Some Information For Citizens
Hypothermia Emergencies: How To Intervene On The Patient
Emergencies, How To Prepare Your First Aid Kit
Seizures In The Neonate: An Emergency That Needs To Be Addressed
Epileptic Aura: The Phase Before A Seizure
Seizures In Children: Types, Causes And Treatments Of Seizures
Spinal Immobilisation Of The Patient: When Should The Spine Board Be Put Aside?
First Aid And Medical Intervention In Epileptic Seizures: Convulsive Emergencies
Airway Management After A Road Accident: An Overview
Ambulance: Common Causes Of EMS Equipment Failures — And How To Avoid Them
Traumatic Injury Emergencies: What Protocol For Trauma Treatment?
Cervical Collar In Trauma Patients In Emergency Medicine: When To Use It, Why It Is Important
What Is Traumatic Brain Injury (TBI)?
Pathophysiology Of Thoracic Trauma: Injuries To The Heart, Great Vessels And Diaphragm
Cardiopulmonary Resuscitation Manoeuvres: Management Of The LUCAS Chest Compressor
Chest Trauma: Clinical Aspects, Therapy, Airway And Ventilatory Assistance
Precordial Chest Punch: Meaning, When To Do It, Guidelines
Ambu Bag, Salvation For Patients With Lack Of Breathing
Blind Insertion Airway Devices (BIAD’s)
UK / Emergency Room, Paediatric Intubation: The Procedure With A Child In Serious Condition
How Long Does Brain Activity Last After Cardiac Arrest?
Quick And Dirty Guide To Chest Trauma
Cardiac Arrest: Why Is Airway Management Important During CPR?
Neurogenic Shock: What It Is, How To Diagnose It And How To Treat The Patient
Abdominal Pain Emergencies: How US Rescuers Intervene
Ukraine: ‘This Is How To Provide First Aid To A Person Injured By Firearms’
6 Facts About Burn Care That Trauma Nurses Should Know
Blast Injuries: How To Intervene On The Patient’s Trauma
What Should Be In A Paediatric First Aid Kit
Ukraine Under Attack, Ministry Of Health Advises Citizens About First Aid For Thermal Burn
Electric Shock First Aid And Treatment
RICE Treatment For Soft Tissue Injuries
How To Carry Out Primary Survey Using The DRABC In First Aid
Heimlich Maneuver: Find Out What It Is And How To Do It
The Patient Complains Of Blurred Vision: What Pathologies Can Be Associated With It?
A Tourniquet Is One Of The Most Important Pieces Of Medical Equipment In Your First Aid Kit
12 Essential Items To Have In Your DIY First Aid Kit
First Aid For Burns: Classification And Treatment
Compensated, Decompensated And Irreversible Shock: What They Are And What They Determine
Burns, First Aid: How To Intervene, What To Do
First Aid, Treatment For Burns And Scalds
Wound Infections: What Causes Them, What Diseases They Are Associated With
Patrick Hardison, The Story Of A Transplanted Face On A Firefighter With Burns
Eye Burns: What They Are, How To Treat Them
Burn Blister: What To Do And What Not To Do
Ukraine: ‘This Is How To Provide First Aid To A Person Injured By Firearms’
Emergency Burn Treatment: Rescuing A Burn Patient