Medications for high blood pressure: here are the main categories
Let’s talk about high blood pressure. Diuretics, beta-blockers, calcium channel blockers, ACE inhibitors, angiotensin II receptor antagonists, alpha-blockers, drugs that act on the central nervous system: it is up to the doctor to choose the most appropriate drug for each case, or possibly a combination to combat high blood pressure
The use of drugs – the side effects of which can be an obstacle to long-term intake – and the health situation in many countries, which does not favour the establishment of a prolonged doctor-patient relationship, are factors that constitute a fundamental condition for maintaining good patient adherence to therapy.
Diuretics, why are they used against high blood pressure?
They lower blood pressure by decreasing the amount of fluid in the circulation.
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However, they are not recommended for those suffering from diabetes and gout, because they tend to increase blood sugar and uricemia, and for those suffering from urinary incontinence, because they increase the amount of urine produced.
How do beta-blockers work?
They act directly on nerve endings, reducing the contractility of the heart and dilating the walls of the arteries.
They are contraindicated if you suffer from asthma, as they promote a narrowing of the bronchi.
High blood pressure and calcium channel blockers
They lower blood pressure by promoting dilation of arterial vessels.
They are indicated in people suffering from ischaemic heart disease (coronary artery disease).
ACE inhibitors
They block the activation by the kidney of a substance that raises blood pressure (angiotensin II).
They are indicated in hypertension, heart failure and diabetes.
In some cases they can cause a wheezing cough.
Angiotensin II receptor antagonists
They act by blocking the angiotensin II receptor, a hypertensive substance produced by the liver (angiotensinogen) and activated by an enzyme produced by the kidney (conversion enzyme).
They appear to be completely free of side effects.
Recommended like the ace inhibitors especially in those with cardiac hypertrophy and diabetic nephropathy as shown by recent studies.
High blood pressure and alpha blockers
These are drugs that cause vasodilation by acting on peripheral vascular nerve endings.
Also used in the medical treatment of prostatic hypertrophy, they can cause (especially when first taken) abrupt and marked reductions in blood pressure.
Drugs with action on the central nervous system
These compounds act directly on the regulation of blood pressure in the central nervous system.
They may interfere with sexual activity (impotence) and cause fatigue and a sense of ‘dry mouth’ (xerostomia).
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