Arterial hypertension (AH, hypertension) is one of the most common pathologies of the cardiovascular system, characterized by a stable increase in blood pressure up to 140/90 mm Hg or higher. The main symptoms of the disease are:
- A headache that does not have a clear relationship with the time of day. Patients describe it as a heaviness in the occipital part, a sensation of the cranium expanding.
- Heart pain that occurs equally at rest and under stress.
- Peripheral vision impairment. It is characterized by the appearance of a veil, ocular opacification, “flies” in front of the eyes.
- Tinnitus, swelling of the eyelids or face are additional symptoms of hypertension.
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An increase in blood pressure develops under the influence of factors of the external or internal environment that provoke a malfunction of the vasomotor, cardiovascular systems and hormonal mechanisms responsible for controlling blood pressure. Doctors attribute a hereditary predisposition to primary factors: if someone in the family has suffered from hypertension, the risk of its development in relatives increases significantly.
Another reason for the development of the disease is frequent stress, nervous work, a sedentary lifestyle. Of the many provoking factors, WHO experts identified those that often contribute to the development of hypertension:
- metabolic disorders in the body and, as a result, the appearance of excess body weight;
- protracted depression, stress, nervous strain, tragedy;
- traumatic brain injuries – abrasions, bruises, accidents, hypothermia;
- chronic diseases in the acute stage – atherosclerosis, diabetes mellitus, rheumatoid arthritis, gout;
- consequences of viral and infectious diseases – meningitis, sinusitis, pharyngitis;
- age-related changes in the structure of blood vessels;
- the formation of cholesterol plaques on the walls of blood vessels;
- menopause in women after 40 years;
- bad habits – smoking, drinking alcohol, malnutrition.
For successful therapy, it is important to diagnose the disease in time and identify the cause of its occurrence. With a properly organized treatment regimen, dangerous complications can be avoided – thrombosis, aneurysm, impairment or loss of vision, myocardial infarction, stroke, development of heart or kidney failure. If a slight increase in blood pressure is detected, the doctor will recommend that you establish proper nutrition, exercise more, and abandon bad habits. Arterial hypertension of the second and third degree is treated with the addition of drug therapy.
The choice of drug is carried out in accordance with the patient’s history. If he has inflammation of the prostate gland, alpha blockers are preferred. People with heart failure or impaired left ventricular function are often prescribed ACE inhibitors (angiotensin converting enzyme inhibitors) and diuretics. In the presence of pain in the region of the heart, Nitroglycerin or Papazol can be prescribed. The choice is made only by the attending physician.
Active participation of the patient in the treatment process significantly increases the chances of recovery, especially if the person understands: what drugs are prescribed for him, how they work, why it is necessary to drink pills. Proper treatment must necessarily take place under the supervision of a doctor, and he must also deal with the selection of the best medicine for the pressure of a new generation.
There is no cure for new generation hypertension, for which the list of side effects is completely absent in the instructions for use. It should be understood that not all patients can experience any negative reactions even after taking potent drugs. If you nevertheless decided to protect the body as much as possible from the appearance of side effects, you should pay attention to herbal medicines, but you do not have to expect instant results from them.
In medical practice, homeopathic medicines are prescribed only with complex treatment as biologically active food supplements. Some of them, in addition to the ability to lower blood pressure, have a number of other useful properties: they stimulate the immune system, cleanse the body of toxins and toxins, and are able to thin out blood clots. Popular homeopathic remedies include:
- Normolife (Normalife).
With sharp jumps, blood pressure increases the load on the heart and blood vessels several times, there is an insufficient flow of oxygen and blood to the tissues of the internal organs, which worsens the patient’s condition. Simple medicines will help calm down – tincture of Valerian, Motherwort. To normalize the pressure, the following new-generation fast-acting drugs are used:
This group of drugs includes drugs that have the ability to gradually accumulate in the body and begin to act actively some time after the start of treatment. Veroshpiron is isolated from weak diuretics. It helps to lower blood pressure, but does not remove potassium from the body.
The most potent drug for hypertension is clonidine, but it is released only by prescription. Simple but effective drugs should not only normalize blood pressure, but also prevent the appearance of new surges in blood pressure and prevent complications. There are several such drugs that have worked well, according to patient reviews:
Beta blocker mechanism of action
The mechanism of action of drugs of this group is due to their ability to block beta-adrenergic receptors of the heart muscle and other tissues, causing a number of effects that are components of the mechanism of the hypotensive effect of these drugs.
- Reduced cardiac output, heart rate and heart rate, resulting in reduced oxygen demand for the myocardium, increased number of collaterals and redistributed myocardial blood flow.
- Heart rate reduction. In this regard, diastoles optimize the total coronary blood flow and support the metabolism of the damaged myocardium. Beta-blockers, “protecting” the myocardium, are able to reduce the area of myocardial infarction and the frequency of complications of myocardial infarction.
- Decrease in total peripheral resistance by reducing renin production by the cells of the juxtaglomerular apparatus.
- Decreased release of norepinephrine from postganglionic sympathetic nerve fibers.
- Increased production of vasodilating factors (prostacyclin, prostaglandin e2, nitric oxide (II)).
- Decreased reverse absorption of sodium ions in the kidneys and the sensitivity of baroreceptors of the aortic arch and carotid (carotid) sinus.
- Membrane-stabilizing effect – a decrease in the permeability of membranes for sodium and potassium ions.
Along with antihypertensive beta-blockers have the following actions.
- Antiarrhythmic activity, which is due to their inhibition of the action of catecholamines, a slowdown in sinus rhythm and a decrease in the speed of impulses in the atrioventricular septum.
- Antianginal activity – competitive blocking of beta-1 adrenergic receptors of the myocardium and blood vessels, which leads to a decrease in heart rate, myocardial contractility, blood pressure, as well as to increase the duration of diastole, improve coronary blood flow. In general, to reduce the oxygen demand of the heart muscle, as a result, tolerance to physical activity increases, periods of ischemia are reduced, the frequency of anginal attacks in patients with exertional angina and post-infarction angina is reduced.
- Antiplatelet ability – slow down platelet aggregation and stimulate prostacyclin synthesis in the endothelium of the vascular wall, reduce blood viscosity.
- Antiox >
Beta-adrenoreceptor stimulation effects
From the table it becomes clear that beta-1 adrenergic receptors are located mainly in the heart, liver and skeletal muscle. Catecholamines, affecting beta-1 adrenergic receptors, have a stimulating effect, resulting in an increase in heart rate and strength.
Depending on the predominant effect on beta-1 and beta-2, adrenergic receptors are divided into:
- cardioselective (Metaprolol, Atenolol, Betaxolol, Nebivolol);
- cardioselective (Propranolol, Nadolol, Timolol, Metoprolol).
Beta-blockers are pharmacokinetically divided into three groups, depending on their ability to dissolve in lipids or water.
- Lipophilic beta-blockers (Oxprenolol, Propranolol, Alprenolol, Carvedilol, Metaprolol, Timolol). When applied orally, it is rapidly and almost completely (70-90%) absorbed in the stomach and intestines. Preparations of this group penetrate well into various tissues and organs, as well as through the placenta and the blood-brain barrier. As a rule, lipophilic beta-blockers are prescribed in low doses for severe hepatic and congestive heart failure.
- Hydrophilic beta-blockers (Atenolol, Nadolol, Talinolol, Sotalol). Unlike lipophilic beta-blockers, when used internally, they are absorbed only by 30-50%, are metabolized to a lesser extent in the liver, and have a long half-life. They are excreted mainly through the kidneys, and therefore hydrophilic beta-blockers are used in low doses with insufficient renal function.
- Lipo- and hydrophilic beta-blockers, or amphiphilic blockers (Acebutolol, Bisoprolol, Betaxolol, Pindolol, Celiprolol), are soluble in lipids and water, after application, 40-60% of the drug is absorbed inside. They occupy an intermediate position between lipo- and hydrophilic beta-blockers and are excreted equally by the kidneys and liver. Drugs are prescribed for patients with moderate renal and hepatic insufficiency.
- Cardiac-selective (Propranolol, Nadolol, Timolol, Oxprenolol, Pindolol, Alprenolol, Penbutolol, Carteolol, Bopindolol).
- Cardioselective (Atenolol, Metoprolol, Bisoprolol, Betaxolol, Nebivolol, Bevantolol, Esmolol, Acebutolol, Talinol).
- Beta-blockers with the properties of alpha-adrenergic receptor blockers (Carvedilol, Labetalol, Celiprolol) are drugs that have inherent mechanisms of the hypotensive effect of both groups of blockers.
Cardioselective and non-cardioselective beta-blockers, in turn, are divided into drugs with and without internal sympathomimetic activity.
- Cardioselective beta-blockers without internal sympathomimetic activity (Atenolol, Metoprolol, Betaxolol, Bisoprolol, Nebivolol) along with antihypertensive effect reduce heart rate, give antiarrhythmic effect, do not cause bronchospasm.
- Cardioselective beta-blockers with internal sympathomimetic activity (Acebutolol, Talinolol, Celiprolol) reduce heart rate to a lesser extent, inhibit the automatism of the sinus node and atrioventricular conduction, give a significant antianginal and antiarrhythmic effect in case of sinus tachycardia, little and supraventricular, supraventricular, and supraventricular -2 adrenergic receptors of the bronchi of the pulmonary vessels.
- Non-cardioselective beta-blockers without internal sympathomimetic activity (Propranolol, Nadolol, Timolol) have the greatest antianginal effect, so they are often prescribed for patients with concomitant angina pectoris.
- Non-cardioselective beta-blockers with internal sympathomimetic activity (Oxprenolol, Trazicor, Pindolol, Wisken) not only block, but also partially stimulate beta-adrenergic receptors. Drugs of this group to a lesser extent reduce heart rate, slow atrial-ventricular conduction and reduce myocardial contractility. They can be prescribed to patients with arterial hypertension with a mild degree of conduction disturbance, heart failure, and a rarer pulse.
Cardioselective beta-blockers block beta-1 adrenergic receptors located in the cells of the heart muscle, juxtaglomerular apparatus of the kidneys, adipose tissue, the cardiac conduction system and intestines. However, the selectivity of beta-blockers is dose dependent and disappears with large doses of beta-1 selective beta-blockers.
Non-selective beta-blockers act on both types of receptors, beta-1 and beta-2 adrenergic receptors. Beta-2 adrenergic receptors are located on the smooth muscles of blood vessels, bronchi, uterus, pancreas, liver and adipose tissue. These drugs increase the contractile activity of the pregnant uterus, which can lead to premature birth.
Cardioselective beta-blockers have an advantage over non-cardioselective in the treatment of patients with arterial hypertension, bronchial asthma and other diseases of the bronchopulmonary system, accompanied by bronchospasm, diabetes mellitus, intermittent claudication.
Speaking of beta-blockers as a class of antihypertensive drugs, they mean drugs with beta-1 selectivity (have fewer side effects), without internal sympathomimetic activity (more effective) and vasodilating properties.
The action of beta-blockers is to block the action on the heart of adrenaline and other catecholamines. As a result, it becomes easier for the heart to work, muscle contractions occur less frequently and less intensively, helping to prevent heart rhythm disturbances. In addition, beta-blockers reduce the production and release of substances that increase blood pressure.
The mechanism of action of beta-blockers is as follows:
- noradrenaline is released;
- the number decreases, the intensity of contractions of the heart muscle;
- decreased vascular tone;
- the central nervous system is inhibited;
- sympathetic influences are reduced.
Due to such exposure to the active substances of beta-blockers, there is a decrease in blood pressure and cardiac arrhythmia, which helps to reduce the likelihood of developing myocardial infarction, ischemia. Beta-blockers help reduce the risk of death from a heart attack or heart failure.
Last Generation Pressure Medication
Several mechanisms are responsible for increasing blood pressure, so some patients require two or more medications at the same time to achieve stable control of blood pressure. To reduce the number of pills taken and reduce the risk of side effects, the drugs for the latest generation of hypertension have been created. There are only five groups of antihypertensive drugs. Classification is carried out according to the composition and principle of action of tablets on the body:
- angiotensin 2 receptor antagonists;
- diuretics (diuretics) drugs;
- calcium antagonists;
- beta – blockers;
- angiotensin converting enzyme inhibitors.
This is a popular group of drugs for new generation hypertension, which are highly effective and versatile. Hypertension can occur from the effects of catecholamines (norepinephrine and adrenaline) on specific receptors located in the heart – beta-adrenergic receptors. This effect causes the heart muscle to contract faster and the heart to beat faster, increasing blood pressure. Beta-blockers stop this mechanism, providing a persistent hypertensive effect.
The first beta blocker was introduced to the world in 1964, and many doctors called the development one of the most important events in medicine. Over time, other drugs with a similar principle of action began to be produced. Some of them affect the functioning of all types of beta-adrenergic receptors, while others affect one of them. Depending on this, beta-blockers are usually divided into three groups:
- First-generation or non-selective medications – block beta-1 and beta-2 receptors. These include: Propranolol, Sotalol, Timolol, Anaprilin.
- Second generation or selective agents – block only beta-1 receptor activity. This group is represented by: Oxprenolol, Metoprolol, Bisoprolol, Esmolol, Atenolol, Betaxolol, Doxazosin, Candesartan, Concor.
- Third-generation drugs with a neurogenic effect – affect the regulation of vascular tone. These include: clonidine, carvedilol, labetalol, nebivolol,
Diuretic drugs are one of the oldest groups of antihypertensive drugs. It was first used in the early 50s of the last century, but diuretics have not lost popularity in our days. Today, diuretics are used to lower blood pressure in combination with other drugs (ACE inhibitors or sartans).
Diuretics help lower your blood pressure by increasing kidney excretion of salt and fluids. Such an effect on the body leads to a decrease in the load on the vessels, contributes to their relaxation. Modern diuretics are used in very low doses, which does not cause a significant diuretic effect, leaching of a large amount of nutrients from the body. Antihypertensive effect occurs 4-6 weeks after the start of treatment.
In pharmacology, there are up to four types of diuretic drugs, but only three of them are used to treat hypertension:
- Thiazide and thiazide-like – belong to the means of prolonged action. They have a mild effect, almost no contraindications. The minus of thiazides is that they can reduce the level of potassium in the blood, which is why it is necessary to assess the patient’s condition every month after taking the tablets. Thiazide diuretics: Hypothiazide, Apo-Hydro, Dichlothiazide, Arifon, Indapamide,
- Loopback – are prescribed only for the diagnosis of high-resistance hypertension. They quickly lower blood pressure, but at the same time contribute to the loss of a significant amount of magnesium and sodium ions, increase the concentration of uric acid in the blood. Loop diuretics – Diuver, Torasemide, Furosemide.
- Potassium-sparing – are used very rarely, because they increase the risk of developing hyperkalemia. These include: Veroshpiron, Spironolactone, Aldactone.
Angiotensin 2 receptor blockers are one of the newest groups of antihypertensive drugs. According to the mechanism of action, they are similar to ACE inhibitors. The active components of sartans block the last level of the renin-angiotensin system, preventing the interaction of its receptors with the cells of the human body.
All sartans act for a long time, the hypotensive effect lasts for 24 hours. With regular use of angiotensin 2 blockers, blood pressure does not decrease below acceptable values. It is worth knowing that these are not tablets for high-pressure quick action. A steady decrease in blood pressure begins to appear 2-4 weeks after the start of treatment and increases by 8 weeks of therapy. Sartans list:
- Losartan (Dimethicone);
These are pharmaceutical drugs that are prescribed for high blood pressure against a background of heart failure, diabetes mellitus, and kidney diseases. Inhibitors of angiotensin-converting enzyme (ACE) change the balance of biologically active blood components in favor of vasodilators, due to which the pressure decreases.
The antihypertensive effect of ACE inhibitors may decrease with the simultaneous use of non-steroidal anti-inflammatory drugs. According to the chemical structure, ACE inhibitors are divided into three groups:
- Sulfhydryl – a short period of time. These are ACE: Zofenopril, Captopril, Lotensin, Kapoten.
- Carboxylic – differ in average duration of action. This group includes: Lisinopril, Enalapril, Khortil, Quinapril, Perindopril.
- Phosphinyl – have a prolonged effect. This group includes: Fosinopril, Ramipril, Perindopril.
Another name for these drugs is calcium channel blockers. This group is used mainly in the complex treatment of hypertension. They are suitable for those patients who have many contraindications to the use of other drugs for new generation hypertension. Calcium inhibitors can be prescribed to pregnant women, the elderly, patients with heart failure.
The basic principle of action of calcium channel blockers is vasodilation by creating obstacles for the penetration of calcium ions into muscle cells. Inhibitors are conventionally divided into three groups: nifedipine (dihydropyridines), diltiazem (benzothiazepines), verapamil (phenylalkylamines). To reduce blood pressure, a nifedipine group is often prescribed. The medicines included in it are divided into subtypes:
- The first generation – Calcigard retard, Cordaflex retard, Nifecard, Nifedipine.
- Means of the second generation – Felodipine, Nicardipine, Plendil.
- Third-class medicines – Amlodipine, Amlovas, Kulchek, Norvask.
- Fourth generation – Cilnidipine, Duocard (very rarely prescribed for hypertension).
Most representatives of the above list are available as tablets for oral use. The exception is only one beta-blocker – Labetalol, which enters the shelves in the form of a powder or solution for intravenous administration. There are other medicines made in the form of injections (for example, sodium nitroprusside, nitrates), but they do not belong to the category of modern medicines and are used exclusively to eliminate the hypertensive crisis.
Modern drugs from pressure in tablets will help to get rid of not only drops in blood pressure, but also improve the functioning of the cardiovascular system, central nervous system and kidneys. Other benefits that new medicines have:
- Unlike systemic drugs, modern hypertension pills can reduce left ventricular hypertrophy.
- They have a selective effect on the body, due to which they are well tolerated by elderly people.
- Do not reduce the performance and sexual activity of patients.
- Gentle to the nervous system. Many drugs contain benzodiazepine, which helps fight depression, stress, and nervous disorders.
Calcigard retard – a new medicine for hypertension with a slow release of the active substance. The drug has high lipophilicity, so it has a long-lasting effect. The active component of the tablets is nifedipine. Auxiliary components – starch, magnesium stearate, sodium lauryl sulfate, polyethylene glycol, stearic acid.
Calcigard retard acts very gently, due to which it can be used for the permanent treatment of hypertension, with stable angina pectoris, Raynaud’s disease. The pharmacological properties of the tablets are slow vasodilation, due to which Calcigard has fewer side effects than pure Nifedipine. Among the negative reactions, the appearance of:
- peripheral edema;
- an allergic reaction;
Calcigard retard is taken orally during or after a meal, the average dose is 1 tablet 2 times a day. With caution, this medicine is prescribed during pregnancy. It is strictly forbidden to treat tablets with:
- hypersensitivity to nifedipine;
- unstable angina;
- severe heart failure;
- acute stage of myocardial infarction;
- severe aortic stenosis.
A striking representative of this group is the drug Diroton. The new generation hypertension medicine is even suitable for the treatment of patients in whom high blood pressure is combined with liver diseases, the drug has a minimum of contraindications and side effects. The active substance of Diroton is lisinopril. Auxiliary components are magnesium stearate, talc, corn starch, calcium hydrogen phosphate dihydrate, mannitol.
The tool has a prolonged effect, so you need to take it once a day in the morning before or after a meal. The main indications for use are:
- arterial hypertension (for monotherapy or combination treatment);
- chronic heart failure;
- acute myocardial infarction;
- nephropathy against diabetes.
With caution, Diroton is combined with potassium-containing diuretics and salt substitutes. Categorical contraindications: history of angioedema, age up to 18 years, hypersensitivity to the components of the tablets, hereditary Quincke edema. Side effects may include:
- nausea with vomiting;
- chest pain;
- skin rash.
Detonic – a unique medicine that helps fight hypertension at all stages of its development.
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.