Drugs for lowering blood pressure classification mechanism of action and contraindications

The advantages of treatment with combined drugs include:

  • ease of use – there is no need to take several tablets at the same time;
  • adherence to therapy – a lower percentage of drug withdrawal;
  • decrease in frequency, severity of side effects;
  • solution of several problems with one medicine;
  • best overall result;
  • reducing the risk of using unwanted, irrational combinations;
  • confidence in the optimality of combinations;
  • lower cost of therapy.

However, this approach has its drawbacks. The main disadvantages of the combined treatment of hypertension include:

  • the inability to adjust the dose of one of the components;
  • limited choice;
  • when adverse reactions occur, it can be difficult to determine which active substance the patient responded to.

Arterial hypertension is a disease in which the patient’s systolic and diastolic blood pressure levels are constantly increasing. They do not decrease on their own, so they require the use of drugs to improve the condition. Today, the acute problem of side effects with the constant use of antihypertensive drugs.

Experts attribute this to improper selection and taking of medications, as well as non-compliance with elementary rules:

  • Diuretic drugs provoke leaching of calcium from the body, which negatively affects the work of the heart, kidneys and other organs.
  • With the constant use of beta-blockers, the absorption of glucose in the body is disturbed, bradycardia develops.
  • Negatively affect health and alpha-blockers, provoke the development of heart failure. In addition, they can reduce pressure to critical levels, leading to fainting and other side effects.
  • Calcium antagonists overly dilate blood vessels, so patients are worried about headache, nausea, dizziness.
  • Angiotensin-converting enzyme inhibitors provoke coughing and allergic reactions.

preparaty dlya snizheniya davleniya 1 - Drugs for lowering blood pressure classification mechanism of action and contraindicationsThe article discusses effective drugs to reduce blood pressure.

Other drugs used to treat hypertensive patients also often lead to adverse reactions. That is why experts insist on a full examination and selection for each patient of the most effective medication with a minimum list of side effects.

Doctors of the treatment departments, district police, ambulance employees are asking people to control the use of drugs. If they are missed, a hypertensive crisis may begin – a sharp increase in blood pressure up to 180 mm Hg or more.

Treatment of sick people begins with tablets that reduce not the force of contractions of the heart muscle, but relieve vascular spasm. Usually, during a crisis, the heart works excessively, but it is difficult to affect its contractions.

Almost always enough tablets are taken 1-2 times before consulting a doctor. Captopril, Nifedipine, Nitroglycerin, Propranolol, Phentolamine and others are used.

The main mistakes are ignoring, late treatment, taking the wrong drugs. Hypertensive (including caffeine) drugs are categorically contraindicated. Also, with hyperkalemia, the main prohibited drugs are ACE inhibitors.

Each group has its contraindications to their appointment. Common are:

  • lack of increase in blood pressure;
  • Normal blood pressure while taking hypertensive drugs, other drugs that increase blood pressure;
  • allergic reactions to the drug or its components; the presence of concomitant diseases (for example, heart attack, kidney disease), the selection of drugs is carried out by a doctor.

The choice of medication depends on specific contraindications for a particular remedy. So, with kidney diseases, it is not always possible to prescribe diuretics and ACE inhibitors.

In some features of the course (hypertension with a long period of normotension), usual dosages can cause hypotension.

Side effects

Most often, doctors prescribe combinations of drugs that they know best. The most popular representatives of complex therapy are given in the table.

Active ingredientsTrade names
Thiazide ACE inhibitors
Hydrochlorothiazide lisinopril
  • Iruside;
  • Lysoretic;
  • Lister.
Hydrochlorothiazide enalapril
  • Burlipril plus;
  • Renipril GT;
  • Enap-HL.
Hydrochlorothiazide ramipril
Indapamide Enalapril
Hydrochlorothiazide captopril
Thiazide sartan
Hydrochlorothiazide losartan
Hydrochlorothiazide telmisartan
Thiazide beta blocker
Chlortalidone atenolol
  • Tenoretic;
  • Tenorm;
  • Tenoric.
Hydrochlorothiazide metoprolol
Hydrochlorothiazide propranolol
Thiazide calcium antagonist
Hydrochlorothiazide amlodipine
Amlodipine indapamide
Sartan Calcium Antagonist
Valsartan amlodipine
  • Artinov AM;
  • Vamloset;
  • Diotensin;
  • Exforge.
Irbesartan Amlodipine
Losartan amlodipine
  • Amzaar;
  • Amlothop Forte;
  • Lozap AM;
  • Lortenza.
ACE inhibitor calcium antagonist
Benazepril Amlodipine
Lisinopril amlodipine
  • De Creese;
  • Tennis
  • Equacard.
Thrandolapril Verapamil ER
Enalapril felodipine
Beta blocker calcium antagonist
Bisoprolol amlodipine
Metoprolol felodipine

The antihypertensive effect of drugs differs depending on its group.

Typically, antihypertensive therapy is prescribed to adults, even with minimal deviations from normal blood pressure (most often with an increase in systolic pressure to 140 mmHg or higher).

There are several groups of different antihypertensive drugs that differ in the mechanism of action, indications, side effects. Modern antihypertensive drugs for continuous use are divided into 5 groups.

They include both tablet forms and injectable solutions. Tablets are prescribed to the patient for use at home or in the hospital, and in hospitals, intravenous infusions (infusions) of drugs are more often prescribed.

Some drugs are prescribed for the long-term treatment of chronic arterial hypertension (hypertension), others are used to quickly reduce pressure.

Medications are in tablet form for oral administration, in the form of injectable solutions (intramuscular, intravenous stream and intravenous drip), in the form of sprays for inhalation (inhalation) or spray under the tongue.

In each group, the most popular representatives with minimal side effects can be distinguished. A combination of two antihypertensive drugs with different mechanisms of action in minimal doses will be ideal.

v4 728px Identify Pills Step 1Bullet1 e1554798535118 - Drugs for lowering blood pressure classification mechanism of action and contraindications

There are several modern and often prescribed antihypertensive drugs:

  1. “Lisinopril” (an angiotensin converting enzyme inhibitor). It is valid for a long time. Enough intake of 10-20 mg for most patients. Reduces blood pressure, as the load on the muscle wall of blood vessels decreases. A possible side effect is a persistent dry cough, at the appearance of which the drug should be canceled. It is not prescribed for certain kidney diseases.
  2. Candesartan (angiotensin receptor blocker). A new antihypertensive drug of the sartans group, which reduces hypertension well. Effective dosages: 8-32 mg per day, a single dose is sufficient. Contraindicated in hyperkalemia (increased levels of potassium in the blood).
  3. “Felodipine” (dihydropyridine calcium antagonist). It reduces systolic (cardiac) output, and therefore reduces blood pressure. It is taken in a dose of 2,5-10 mg per day with the control of urine output (daily urine volume).
  4. Nebivolol (cardioselective beta-blocker). Like analogues, these cardioselective drugs reduce the power of heart contractions. A single dose of 5-10 mg is enough. It is important to control your blood pressure after taking it.
  5. Indapamides (thiazide-like diuretics). These are the next most common prescriptions for ACE inhibitors. Increase the volume of urine released, which reduces the volume of blood and its pressure on the blood vessels. Allowed 1,25-5 mg of drugs per day with a careful calculation of diuresis.

Antihypertensive drugs and drugs, in the first place, are dangerous with a sharp decrease in blood pressure. Also, side effects include nausea, decreased attention, dizziness, and weakness.

Some groups have their own characteristics of side effects (ACE inhibitors sometimes cause coughing).

To achieve a quick result with a sharp increase in blood pressure, the patient must take a medicine that reduces blood pressure in a few minutes. As a rule, doctors prescribe calcium channel blockers, because they instantly reduce the load on the heart and dilate blood vessels. The most commonly used are Nifedipine, Pharmadipine, Verapamil, Amlodipine.

Additionally, to achieve a pronounced hypotensive effect, loop diuretics are prescribed, for example, Furasemide, Lasix. In the absence of results, angiotensin-converting enzyme inhibitors, for example, Captopril, are used.

In some cases, it is better to take a combination agent that has a hypotensive and diuretic property. The most effective is Captopress. In each case, the doctor individually selects the medicine.

Long-acting medications allow the patient to take drugs once a day and maintain indicators at the same level, avoiding the development of a crisis. However, many of them provoke a dry cough, so patients avoid taking them.

Blockers of calcium channels and angiotensin receptors, alpha-blockers, diuretics do not provoke the development of cough, and do not worsen the condition of the patient.

c8a695c356379a3684e3a78b523d5f6a - Drugs for lowering blood pressure classification mechanism of action and contraindications

The most effective means of these groups: Hydrochlorothiazide, Doxazosin, Triampur, Cardosal, Minoxidil. Despite the relative safety, doctors do not recommend taking medications without examination.

Rapid Pressure Pills

The effectiveness of the combination of active substances depends on the correctness of their selection. The components of the drug must meet the following conditions:

  • complement the positive action of each other;
  • level negative effects of each other;
  • improve performance compared with the use of active substances separately;
  • have a similar duration of action;
  • convenient reception mode.

According to the recommendations of the European Society of Hypertension and the European Society of Cardiology, all combinations of drugs to normalize blood pressure can be divided into several groups:

  • preferred (blue solid line) – are assigned first;
  • expedient (blue dashed line) – it is allowed to use certain categories of patients with some restrictions;
  • possible (black dotted line) – poorly studied combinations;
  • not recommended (orange line).

Preferred combinations include:

  • thiazide diuretics ACE inhibitors;
  • thiazide diuretics calcium antagonists;
  • thiazide diuretics angiotensin II receptor blockers (sartans);
  • angiotensin II receptor blockers (sartans) calcium antagonists;
  • ACE inhibitors calcium antagonists.

Reception of diuretics is accompanied by undesirable stimulation of the activity of RAAS, the release of a large amount of potassium, magnesium, a violation of carbohydrate, fat metabolism. ACE inhibitors, sartans, on the contrary, block RAAS, reduce the excretion of these ions. Some members of the class also normalize lipid, carbohydrate metabolism.

Due to the effect on two main mechanisms of increasing blood pressure (retention of sodium, body fluids, activation of RAAS), the simultaneous use of thiazides, ACE inhibitors or sartans allows you to achieve a better result. Successful control of blood pressure is achieved in 80-85% of patients. For comparison: ACE inhibitor monotherapy is effective only in half of patients, sartans – 56-70%.

Level the main disadvantages of each other, increase the effectiveness of treatment. Diuretics eliminate sodium retention, which may be accompanied by calcium antagonists. And vice versa: the use of drugs of the second group minimizes the risk of tachycardia, potassium deficiency, activation of RAAS caused by a diuretic.

The ability of these two groups of drugs to enhance the effectiveness of each other is explained by the influence on various mechanisms of blood pressure control. ACE inhibitors inhibit the activity of RAAS, the sympathetic nervous system, which reduce the effectiveness of calcium antagonists.

With this combined treatment of hypertension, there is a decrease in the risk of developing undesirable reactions: swelling of the legs, tachycardia, characteristic of calcium channel blockers.

The combination of the two drugs also significantly reduced the risk of cardiovascular complications (by 20%) compared with the group of patients who received the classic ACE inhibitor diuretic (3).

Of all the preferred combinations, this combination has the largest number of indications (4). They are prescribed for:

  • isolated systolic hypertension;
  • thickening of the wall of the left ventricle of the heart;
  • chronic heart failure;
  • nephropathy;
  • excretion of albumin in the urine (albuminuria);
  • metabolic syndrome;
  • diabetes mellitus;
  • dry cough caused by taking ACE;
  • suitable for elderly patients.

A more pronounced hypotensive effect when taken together is due to the mutual complement of the mechanism of action of drugs. Calcium channel blockers reduce the intake of calcium into the muscle cells of blood vessels, and sartans prevent the binding of their receptors to angiotensin 2. Also, both drugs eliminate some of the negative effects of each other.

Sharing these medications is not recommended for most patients with arterial hypertension. However, their use is more than justified in certain categories of persons. First of all, these are patients with angina pectoris. Several large-scale studies have proven: in case of heart failure, the simultaneous administration of calcium channel blockers, beta receptors can reduce overall, cardiovascular mortality.

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With persistent arterial hypertension, even the use of two active substances can be ineffective. In this case, it is recommended to connect the third, sometimes even the fourth component.

Active substanceTrade names
Amlodipine Valsartan Hydrochlorothiazide
  • Co-Vamloset;
  • Co-Exforge;
  • Tritensin.
Amlodipine indapamide lisinopril
Amlodipine indapamide perindopril

There are also three-component drugs in which two active substances – antihypertensive drugs, and the third – solves the problem associated with hypertension. Most often it is a statin, which reduces the level of total, bad cholesterol, neutral fats, increases the concentration of good.

Active ingredientsTrade names
Amlodipine atorvastatin perindoprilHypertans
Amlodipine lisinopril rosuvastatinEquamer

Sharing drugs can enhance each other’s negative effects or be ineffective. Therefore, in the combined treatment of hypertension, it is not recommended to combine the following drugs (5).

CombinationPossible consequences
ACE SartansIncreased risk of developing end-stage kidney disease, stroke, especially in patients with diabetes
Diuretic vasodilatorsHypokalemia
Diuretic beta-blockerHypokalemia, dyslipidemia
Non-dihydropyridine calcium antagonist beta-blockerAtrioventricular block, bradycardia
Dihydropyridine Calcium Antagonist Alpha BlockerLow pressure
Alpha blocker diureticOrthostatic hypotension, “first-dose effect”
ACE inhibitor/Sartan potassium-sparing diureticIncreased potassium concentration
ACE inhibitor alpha/blockerHypotension
Hydralazine dihydropyridine AKTachycardia, myocardial ischemia

Also, when prescribing complex drugs, the status of the patient, the presence of concomitant diseases are taken into account:

  • the combination of a calcium antagonist sartan/ACE inhibitor is contraindicated in case of serious renal problems, severe liver failure, heart failure after myocardial infarction, aortic narrowing;
  • beta-blockers thiazides are not used for the treatment of patients with bradycardia, low blood pressure, atrioventricular block, sinus node syndrome, pheochromocytoma, not controlled by heart failure;
  • co-administration of ACE/Sartan diuretics is not recommended for patients with obstruction/narrowing of the biliary tract, severe hepatic/renal impairment, hypokalemia, hypercalcemia.

Most combination drugs are contraindicated in pregnant, lactating women.

A quick effect from taking medications is required mainly in emergency cases when blood pressure is especially high. Fast-acting drugs include captopril, furosemide, anaprilin, enalapril, adelfan. Usually their effect occurs literally in 10-30 minutes.

The main disadvantage of drugs that reduce high blood pressure in a short time is the short duration of the action. Usually, such medications have to be taken 3-4 times/day.

They are most often prescribed to people with 2,3 stages of hypertension, who are shown lifelong intake of antihypertensive drugs.

Long-acting drugs are prescribed outside the stage of exacerbation. It is enough to take them 1-2 times/day. The maximum antihypertensive effect is manifested after 3-6 weeks from the start of treatment. During this time, the pressure will gradually drop to the target numbers. The smooth effect avoids the complications typical of a rapid decrease in blood pressure, as well as avoiding pressure surges in the future.

List of long-acting drugs:

  • Bisoprolol;
  • Metoprolol;
  • Propranolol;
  • Losartan;
  • Cordaflex;
  • Prestarium
  • Diroton.

Different medications are suitable for young people and elderly patients. Pregnant women are prescribed the safest drugs, men with severe signs of cardiovascular disease – potent.

Detonic – a unique medicine that helps fight hypertension at all stages of its development.

Detonic for pressure normalization

The complex effect of plant components of the drug Detonic on the walls of blood vessels and the autonomic nervous system contribute to a rapid decrease in blood pressure. In addition, this drug prevents the development of atherosclerosis, thanks to the unique components that are involved in the synthesis of lecithin, an amino acid that regulates cholesterol metabolism and prevents the formation of atherosclerotic plaques.

Detonic not addictive and withdrawal syndrome, since all components of the product are natural.

Detailed information about Detonic is located on the manufacturer’s page www.detonicnd.com.

For young people

Young patients are usually prescribed drugs with a minimal list of contraindications and side effects, since the increase in blood pressure is not constant and is easily corrected.

Name and compositionMedicinal propertiescontraindications
Raunatin (Rauwolfia alkaloids)Due to the presence of plant components in the composition, it has a mild effect at the initial stage of hypertension, prevents vasoconstriction, reduces the heart rate, and has a mild sedative propertyNot used for myocarditis, severe hypotension, under the age of 18 years, during lactation and pregnancy, gastric ulcer and intolerance to the components of the product
Lisinopril (lisinopril dihydrate)The active substance of the drug reduces pressure, dilates blood vessels, prevents the development of arrhythmias, restores myocardial cellsIt is not used during pregnancy and lactation, with allergies to the components of the drug, gout, high potassium in the blood, diseases of the kidneys and liver of a severe form
Veroshpiron (spironolactone)The active component has a pronounced diuretic effect, which helps to reduce pressure, but does not provoke leaching of potassium from the body and does not disrupt the functioning of the heartIt is not prescribed during lactation and pregnancy, with severe severe renal failure, allergies to the components of the drug, in childhood
Losartan (losartan potassium)A tool from the group of sartans that has a pronounced hypotensive property. Quickly reduces performance after the first dose, well tolerated, facilitates heart functionContraindicated during lactation and pregnancy, with hypersensitivity to the components of the composition

Despite the relative safety of funds, experts do not recommend self-administration without examination.

For pregnant


Antihypertensive drugs are a large group of drugs with many different active ingredients and a huge number of trading combinations.

  • angiotensin converting enzyme inhibitors (ACE inhibitors);
  • angiotensin receptor blockers;
  • calcium antagonists;
  • beta blockers;
  • diuretics (diuretics).
  • non-selective adrenergic blockers (alpha and beta blockers);
  • alpha 2-adrenomimetics;
  • rauwolfia preparations;
  • other drugs.

The antihypertensive effect of each group is not the same: some quickly and briefly lower the pressure, others begin to act after a few hours and stop after tens of hours.

Most patients are prescribed first-line drugs for continuous use. One or several funds a person must take one or more times a day.

Before taking and throughout the day, you need to control your blood pressure, at unusually low – reduce the dosage of the drug or cancel the reception on this day, and then consult your doctor.

The second row of drugs is used less often due to more pronounced side effects. So, central antihypertensive drugs can reduce pressure too quickly, but the subsequent effect is a sharp increase in blood pressure.

0a947d15a73b740a1ce2c6cd87e9e013 - Drugs for lowering blood pressure classification mechanism of action and contraindications

Inhibitors of an angiotensin-converting enzyme is the name of one of the commonly used groups of quick-acting antihypertensive drugs. Their mechanism of action is associated with the biochemical “renin-angiotensin-aldosterone” system.

This is a sequential transformation and change of hormones that begin in the nephrons (the structural unit of the kidney) and end with the creation of hormones with a hypertensive effect.

The kidneys are one of the organs directly involved in controlling blood pressure. During blood filtration in the renal glomeruli, special cells control the blood flow velocity and, if necessary, signal insufficient blood flow.

This is how renin is produced – an inactive substance that immediately begins to transform into more hypertensive forms.

First, angiotensinogen is created, and from it – angiotensin (AT), the reaction occurs with the participation of the angiotensin-converting enzyme (ACE). Then angiotensin is fermented to aldosterone, and these two hormones significantly increase blood pressure.

The hypotensive effect of ACE inhibitors is associated with blocking the renin-angiotensin-aldosterone system, which is often included in the work with insufficient renal circulation.

In healthy people, this happens only with a decrease in pressure, but often the RAAS begins to function in violation of the structure or function of the renal vessels (inflammation, autoimmune processes, atherosclerosis, and other causes).

One possible side effect is the appearance of a dry cough. Blocking the enzyme leads to disruption of other hormonal systems, which, ultimately, can manifest itself in the form of an insignificant, constant dry cough, which can not be removed.

If the cough appeared shortly after the start of taking ACE inhibitors and stops with their withdrawal, then this group of drugs is not suitable for this patient.

ACE inhibitors and diuretics act on the kidneys to reduce pressure. The mechanisms of work are different, but all three groups need to be used especially carefully in the presence of renal diseases.

The most commonly used representatives of the ACE inhibitor group are:

  1. “Enalapril” (in a dosage of 5-40 mg, taken 1-2 times a day);
  2. “Captopril” (25-100 mg, 1-3 doses per day);
  3. “Lisinopril” (10-40 mg, 1-2 times a day);
  4. “Ramipril” (2,5-20 mg, 1-2 times a day);
  5. Other drugs (usually end with adj).


Angiotensin II receptor blockers (ARBs) also act on the renin-angiotensin-aldosterone system. If ACE inhibitors work poorly or cannot be assigned, you can use AT blockers.

Such antihypertensive drugs (PM) block specific receptors that respond to the presence of angiotensin in the blood, and this reduces its effect.

Hypotension as a hypotensive effect is not achieved immediately: depending on the drug, recovery can occur only after a week.

They are usually prescribed for hypertension associated with pathology of the kidneys or heart. Side effects are rare. Contraindications – stenosis (narrowing) of the renal arteries.

The most popular representative is Valsartan. Take it in a dosage of 80-320 mg per day.

preparaty dlya snizheniya davleniya 8 - Drugs for lowering blood pressure classification mechanism of action and contraindications

This group of antihypertensive drugs also includes all sartans: Telmisartan (20-80 mg per day), Irbesartan (in a daily dosage of 150-300 mg), Losartan (50-100 mg per day), “ Candesartan “(8-32 mg per day) and others.

Calcium antagonists

A group of calcium antagonists exerts its effect on specific calcium channels in the myocardium. For muscle contraction, the transition of certain ions from the cell to the outside is necessary, and in return, the entry of other molecules.

During relaxation, the reverse movement occurs. Heart muscle cell channels that allow Ca2 ions to pass through can be temporarily blocked, thereby reducing the frequency and strength of heart contractions.

If systole occurs less intensively, the manifestations of arterial hypertension are reduced.

It also affects the muscle layer of blood vessels: arteries that feed the heart expand. Due to this effect, calcium antagonists are often prescribed for people with angina pectoris.

Do not cause side effects in people with heart failure, which is treated with Digoxin, diuretics, ACE inhibitors.

There are 3 groups of calcium antagonists, because each has its own mechanism of action:

  1. Derivatives of phenylalkylamine.
  2. Derivatives of benzodiazepine.
  3. Derivatives of dihydropyridine.

Each subspecies of the calcium antagonist group has side effects and prescribing features. AK are used for smooth pressure reduction, its constant control. Antihypertensive agents of this group are:

  1. “Amlodipine” – taken at 2,5-10 mg per day;
  2. “Nifedipine” – 20-120 mg per day;
  3. “Verapamil” – 120-480 mg per day in 1-2 doses;
  4. “Diltiazem” – 120-480 mg per day.
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Adrenaline and norepinephrine (catecholamine hormones) tend to increase pressure by narrowing blood vessels or increasing heart contractions.

The β-adrenergic receptors (beta) are located in the myocardium, which, when catecholamines are detected, increase the strength of contractions and increase their frequency.

As we studied the effect of this group, it was found that antihypertensive drugs act on other organs.

It turned out that beta-blockers can act non-selectively: there are sensitive receptors not only in the heart, but receptor blockade in other organs leads to side effects of the drug.

Now there are two groups of antihypertensive drugs of the beta-blocker group: cardioselective (act selectively on β2-adrenergic receptors of the heart) and non-cardioselective. In the treatment of hypertension, preference is given to selective.

Doctors often prescribe combinations: diuretics beta-blocker, calcium antagonist beta-blocker.

Some representatives of beta-blocks are slow and should be taken for a long time in tablet form, others quickly reduce pressure.

So, with adrenal insufficiency, “Phentolamine” is administered intravenously for a sharp decrease in blood pressure). It is pointless to give a tablet of a similar drug that exhibits such a hypotensive effect – the absorption rate will be too small.

  1. “Atenolol” – taken at 12,5-50 mg 2 times a day;
  2. “Bisoprolol” – 2,5-20 mg per day;
  3. “Carvedilol” – 12,5-50 mg per day, taken 1-2 times a day.


These drugs have long been used to treat hypertension. Initially, the diuretic effect of plants was used, now they use tablet forms and injectable solutions more often.

The antihypertensive effect of diuretics is based on the fact that liquid is eliminated from the body (primarily from the blood). So the blood volume decreases, but with a constant volume of blood vessels, blood pressure decreases.

The use of this type of antihypertensive drugs is possible only with careful monitoring of the volume of fluid drunk and the volume of urine.

There are 5 groups of diuretics according to the mechanism of action:

Thiazide and thiazide-like increase the content of potassium in the urine, and each potassium ion “holds” several water molecules next to it. Loops reduce the absorption of sodium and chlorine ions from primary urine, which also enhances the secretion of water.

Potassium-sparing ones block the action of aldosterone, which limits the release of sodium and fluid along with it. Osmotic create an additional osmotic effect, in which a larger volume of urine is excreted.

The main diuretics are:

  1. “Furosemide” – from 20 to 480 mg per day, from one dose to six;
  2. “Spironolactone” – 25-100 mg per day, 3-4 doses;
  3. “Hydrochlorothiazide” – 12,5-50 mg, 1-2 times a day;
  4. “Indapamide” – 1,25-5 mg, 1 time per day.


The antihypertensive effect of traditional medicine is often associated with psychological factors. The antihypertensive properties of such substances are often not proven, but a person, expecting to get a real result, unconsciously sets himself up for improvement.

The ability to take folk remedies to lower blood pressure is great, but it is highly advisable to combine them with other pharmacy antihypertensive drugs. This means that the hypotensive effect of these drugs can be summarized.

Sometimes an overdose leads to hypotension – a too pronounced drop in pressure.


  1. Zh.D. Kobalava. The place of combined antihypertensive therapy in the modern treatment of arterial hypertension, 2007
  2. ON THE. Vaulin. Combination Therapy for Hypertension: A Focus on Unfixed Combinations, 2011
  3. Skvortsov BB, Tumarenko A.B. Combination treatment of hypertension: emphasis on the combination of calcium antagonists and ACE inhibitors, 2011
  4. Zadionchenko V.S., Schikota A.M. other. The algorithm for choosing a drug for the treatment of arterial hypertension, 2017
  5. Gu >f5945e7133343ee91a798ec275abc702 - Drugs for lowering blood pressure classification mechanism of action and contraindications

Higher medical education. Kirov State Medical Academy (KSMA). The local therapist.

More about the author

Last Updated: October 7, 2019

  1. Matthew R Alexander. Hypertension Medication, 2018
  2. Wright JM, Musini VM, Gill R. First-line drugs for hypertension, 2018
  3. Suzanne R. Hill, Anthony J. Smith. First-line medicines in the treatment of hypertension, 2005
  4. Richard N. Fogoros, MD. The Drugs Commonly Used to Treat Blood Pressure, 2018

How to take drugs for high blood pressure

Drugs to reduce pressure are divided into several groups depending on the mechanism of action.

The following are the main and often used:

  • Beta-blockers directly affect the functioning of the heart, reduce the frequency of its contractions, which leads to a decrease in pressure within the vascular bed.
  • Calcium channel blockers usually have a pronounced effect and quickly reduce blood pressure. This is due to relaxation of the myocardium, a decrease in heart rate and vascular tone. The heart muscle does not need a large amount of oxygen, which allows you to normalize the pressure.
  • Antispasmodics that affect smooth muscle fibers. They help to relax the walls of blood vessels, reduce the load on the heart and facilitate the work of the myocardium. As a result, indicators are reduced, but not significantly.
  • Nitrates have a pronounced effect due to a sharp expansion of blood vessels. Pressure decreases very quickly, but medications provoke a lot of adverse reactions, so they are prescribed only by a doctor after an examination.
  • Alpha-adrenergic blockers are not prescribed to patients with hypertension so often, as they can provoke negative reactions. Patients with glaucoma, severe neurological diseases, they are contraindicated. Despite this, drugs quickly reduce pressure by blocking the substances that cause its increase.
  • Sympatholytics have moderate hypotensive properties, often contain herbal components that help to reduce performance. With severe arterial hypertension, they are not able to significantly improve the patient’s condition, therefore they are usually used at the initial stage of the disease.
  • Diuretics, or diuretics, are in most cases used as part of the complex treatment of hypertension. When taking drugs, the blood volume in the vascular bed is significantly reduced, which reduces pressure and facilitates the work of the heart muscle. Patients with heart failure and edema need such medications.
  • Alpha stimulants reduce the activity of the sympathetic nervous system, which leads to a significant decrease in blood pressure. They are prescribed with caution, have a pronounced sedative effect, often provoke adverse reactions.
  • ACE inhibitors (angiotensin-converting enzyme) help reduce blood pressure quickly, but are prescribed only to patients who do not have problems with the respiratory system. Differ in soft action and do not provoke addiction.
  • Sartans today are considered the best for lowering blood pressure. They are less likely than others to provoke complications and are well tolerated by patients of different ages.

Each type of antihypertensive drugs has its advantages and disadvantages. In most cases, the appointment of several drugs from different groups is required to achieve a therapeutic effect. In addition to this classification, doctors divide drugs into fast-acting, prolonged and combined.

Medicines with antihypertensive effect must be taken correctly in order to get the maximum benefit and minimize negative reactions. For each patient, indicators increase at different times of the day. For several years, experts conducted experiments in which different people took part.

During these studies, it was found that taking antihypertensive drugs in the evening allows you to better control indicators throughout the day. Patients who took the medicine in the morning felt much worse, and they experienced crises more often than those who took the drugs in the evening.

It was the results of the study that allowed doctors to develop a treatment regimen for patients with hypertension. They prescribe drugs for administration in the evening, which allows to achieve the maximum therapeutic effect and maintain performance within normal limits. Additionally, it is recommended not to exceed the dosage.

Drugs to reduce blood pressure may become ineffective after administration over a long period, but it is not recommended to independently exceed the dosage. In addition, you should not combine drugs with other potent medicines during one dose.


preparaty dlya snizheniya davleniya 6 - Drugs for lowering blood pressure classification mechanism of action and contraindications

Antihypertensive drugs – an important group of drugs for the treatment of one of the most common modern diseases (arterial hypertension).

A variety of groups of antihypertensive drugs allows each patient to choose the right medicine.

You can only cancel drugs on your own if there are sharp adverse reactions or complications, in other cases, temporarily reduce the dosage and consult a doctor about further treatment.

Why are several drugs taken with arterial hypertension?

Pressure reduction medications are not universal. For each patient, the specialist selects the most suitable remedy. The first step is to examine and identify the true cause of the increase in indicators.

In some, hypertension is provoked by an improper lifestyle, in others it becomes a consequence of diseases of the kidneys and other internal organs, many patients are often stressed, so the indicators increase. In each case, the treatment regimen will be different.

The specialist will prescribe the appropriate tests, determine the general condition of the patient. An ECG is required to evaluate the functioning of the heart. Ultrasound of the kidneys is sometimes necessary, the method allows to identify organ diseases. Additionally, the patient’s age and associated diseases are taken into account. It is especially important to exclude go confirm the presence of neurological diseases.

Particularly carefully selected medicines for women during pregnancy. After choosing the right medicine, the patient takes it for some time. The specialist monitors the condition, notes deterioration or improvement to determine the effectiveness of the drug. If necessary, another medication is prescribed.

Hypertension is usually provoked by several predisposing factors, not only the heart suffers, but also the vessels, as well as the kidneys and other internal organs. Therefore, doctors prescribe immediately 2-3 drugs from different groups to make treatment as effective as possible and exclude the likelihood of developing a hypertensive crisis.

Only a doctor should combine medicines. It usually combines beta-blockers with diuretics (Bisoprolol and Hydrochlorothiazide). It is allowed to take diuretics with ACE inhibitors (captopril with hydrochlorothiazide). It is considered effective to take calcium channel blockers in combination with beta-blockers (Metoprolol and Felodipine).

preparaty dlya snizheniya davleniya 3 - Drugs for lowering blood pressure classification mechanism of action and contraindications

Sartans and diuretics also work well when taken concomitantly (Lazartan and Hydrochlorothiazide). It is forbidden to combine the means of one group or independently draw up a treatment regimen. It is also contraindicated to use more than three medicines to reduce pressure at the same time.

Drugs for normalizing blood pressure indicators help control numbers and prevent crises. Pressure reduction is carried out using different means, but they should be selected by a specialist.

Medications for high blood pressure

Diastolic, or lower blood pressure is an indicator that allows you to evaluate the work of the heart during its maximum relaxation. With its regular increase, patients are prescribed medications to normalize the numbers. These include beta-blockers, calcium antagonists, and vasodilators.

The most effective drugs to lower the bottom rate are as follows:

Medicines have a pronounced effect, reduce heart rate, prevent complications.

Tatyana Jakowenko

Editor-in-chief of the Detonic online magazine, cardiologist Yakovenko-Plahotnaya Tatyana. Author of more than 950 scientific articles, including in foreign medical journals. He has been working as a cardiologist in a clinical hospital for over 12 years. He owns modern methods of diagnosis and treatment of cardiovascular diseases and implements them in his professional activities. For example, it uses methods of resuscitation of the heart, decoding of ECG, functional tests, cyclic ergometry and knows echocardiography very well.

For 10 years, she has been an active participant in numerous medical symposia and workshops for doctors - families, therapists and cardiologists. He has many publications on a healthy lifestyle, diagnosis and treatment of heart and vascular diseases.

He regularly monitors new publications of European and American cardiology journals, writes scientific articles, prepares reports at scientific conferences and participates in European cardiology congresses.