Arterial hypertension is one of the most common types of pathologies of the cardiovascular system, which is getting younger every year.
The lack of timely treatment of the disease leads to premature wear of the heart and blood vessels, resulting in the development of life-threatening complications: cardiac ischemia, strokes, heart attacks, hypertensive crises and even death.
In order not to bring your body to a “borderline” state in the bad sense of the word, you need a comprehensive regular medication. The best result in the fight against hypertension is given by modern drugs.
The treatment of hypertension is complex. To achieve the desired effect, a versatile effect on the patient’s body is required. For this, a new generation of drugs is prescribed to the patient.
They are perfectly adapted to the conditions in which a modern patient is being treated, and are maximally improved, thanks to which they have the ability to quickly impact.
As a rule, modern hypertensive patients, on the recommendation of their attending physician, take the following groups of drugs as part of a single course or for prophylactic purposes:
sedatives. The patient’s calm state is the key to normalizing his state of health. And since high blood pressure often disrupts the functioning of the heart and blood vessels, which provokes the development of a panic, depression or insomnia, sedatives play an extremely important role. Thanks to them, a complete rest becomes possible. Also, sedatives are simply necessary for those people who have developed hypertension am >
The listed funds are among the popular medicines used by modern doctors in the fight against hypertension. In addition to the type of exposure, all new-generation drugs used to treat hypertension can also be divided into several other categories.
Blood pressure never rises just like that. Increased numbers on the tonometer scale are a consequence of disturbances in the operation of individual organ systems.
One of the most important regulators of blood pressure indicators is the sympathetic nervous system. Pathologies in its functioning can lead to sharp jumps or stably increased pressure.
To eliminate this pathology, central-action drugs are used that provide a decrease in sympathetic impulse to the heart and blood vessels. Active substances inhibit the vasomotor center, due to which there is a decrease in blood pressure.
The following drugs are classified as central agents:
- other drug options.
Most centrally acting drugs have a fairly “powerful” composition, therefore, they can cause not only side effects, but also withdrawal symptoms.
To prevent this from happening, taking funds from this category is necessary exclusively under the supervision and as prescribed by the attending physician.
This is a new generation of products, which contain 2-3 active substances. Due to this feature, drugs of this group have a longer period of exposure to the body, so they are taken once a day.
The prolonged action of combined drugs requires careful monitoring of the patient’s condition in the first days of admission.
Overdoses and an independent increase in the amount of the drug used are unacceptable. Such actions can lead to a sharp drop in blood pressure and deterioration.
A separate group of antihypertensive drugs that give a good effect include medications that can act directly on the walls of blood vessels – myotropic and neurotropic – eliminating a spasm of smooth muscles of the body’s tissues and relaxing vessels.
Such medications contribute to a rapid decrease in performance. Only the attending physician should prescribe the drug, determine its dosage and duration of administration, based on the results of the tests, the severity of the disease, and the patient’s health status.
Myotropic antihypertensive drugs include Nitroglycerin, Sodium nitroprusside, Minoxidil and others. The group of neurotropic drugs includes clonidine and many other drugs.
Supplements or dietary supplements are another effective tool that can give a good effect in the fight against hypertension.
Such preparations contain substances of natural origin, the action of which is aimed at normalizing the functioning of the heart and blood vessels, as well as at restoring normal blood pressure parameters.
Supplements are consumed with food, adding them to regular food. Bioadditive does not spoil the taste of the main products and at the same time positively affects the state of the body.
Depending on the composition, dietary supplements may also differ in other beneficial properties.
In order for BA pressure to give the desired effect, it is necessary to follow the diet prescribed for hypertensive patients: eat less salty, spicy, sweet, fried and fatty foods, choosing cereals, vegetables, fruits, dairy products with a low content of fats and low-fat varieties of meat and fish.
Hypertensive patients are recommended to use the following types of dietary supplements:
Cardiol. Barter pressure is indicated for people with hypertension, as well as athletes. Helps to avo >
Fluctuations in blood pressure are the main cause of many pathologies. In this case, not only blood vessels and the heart can suffer, but also practically all systems and organs. Patients suffering from hypertension should undergo preventive examinations on a regular basis and appropriate treatment.
Therapy for hypertension includes maintaining a healthy lifestyle, proper nutrition, stopping the use of alcohol and tobacco, playing sports, as well as taking medications.
Many proven drugs for hypertension have a lot of contraindications and often cause negative reactions of the body, so a number of safer drugs have been developed. New generation medicines help to avoid the progression of pathology and side effects, and also significantly improve the patient’s quality of life.
For the treatment of hypertension, drugs belonging to different groups are used. The best effects are complex medicines. Thanks to them, the performance of many organs and systems improves.
New generation medicines are classified according to changes in pressure coordination. Preparations of all groups – to restore the usual pressure for the body without negative consequences. The following groups of such drugs exist:
- Soothing. Due to the effect of drugs on the nervous system, the production of adrenaline decreases and a protective effect on the blood vessels of the person occurs. Often, sedatives are prescribed in the form of tablets containing valerian and mint. The only negative of such drugs is the inhibition of the body’s reactions and the duration of the action.
- Aimed at normalizing blood flow. Due to their action, the lumen of the vessels increases. This list includes myotropic (affecting the walls of blood vessels) and neurotropic drugs (normalize the functioning of the central nervous system departments responsible for muscle tone). The disadvantages of these medications include: heart palpitations, severe sweating. This should be considered when choosing medications, because they will not be suitable for people suffering from atherosclerosis and ischemia.
- Diuretic agents. They rid the body of excess fluid and salts. When there is a lot of water in the body, additional pressure is created. Old diuretic drugs have a very big minus – potassium is excreted from the body, forming excess calcium salts.
- Beta blockers, inhibitors. These medicines are used relatively recently and have already managed to gain popularity among patients. The principle of action of these substances is the direct effect of the components on the cells, exercising control over all metabolic processes in the body. Often, experts prescribe these drugs if hypertension occurs due to an increased sugar content in the body. In addition, they are suitable for people with malfunctions of the thyroid gland and urinary organs.
- Approach to prescribing drug therapy for high blood pressure
- Beta blockers
- ACE Inhibitors
- Calcium inhibitors
- Diuretic drugs
- Angiotensin inhibitors
- Combination therapy: for or against?
- Fixed drug combinations
- Simultaneous administration of three drugs for hypertension
- Selective agonists of imidazoline receptors
- What to do if the medicine lowers blood pressure too much
- Myotropic antispasmodics
- What medications for hypertension are the most harmful
- Complex drugs for pressure
- We turn to the natural treatment of hypertension
Approach to prescribing drug therapy for high blood pressure
Arterial hypertension is one of the most common pathologies of the cardiovascular system. High blood pressure can pose a significant risk to the patient, contributing to the development of severe consequences, including heart attack and stroke.
Patients with arterial hypertension, as well as people at risk, often wonder if there are drugs on the pharmaceutical market for new generation pressure without side effects and without getting used to and how to choose the most effective way to lower blood pressure (BP). Unfortunately, there are no absolutely harmless medicines without contraindications.
Even the safest drugs with minimal side effects can be contraindicated to the patient due to the individual intolerance of one or another component. With arterial hypertension, self-medication and uncontrolled taking antihypertensive drugs is not recommended, as this can cause a deterioration in the patient’s condition and the development of complications. The list of pressure pills without side effects that can be used in a particular case can only be made by a qualified specialist.
With hypertension, the patient is trying to choose a remedy that is most effective and safe, taking into account the existing symptoms, contraindications and a number of other factors. So, women are prescribed drugs during pregnancy with arterial hypertension, when using which the risk of negative effects on the developing fetus is minimized.
Antihypertensive drugs have different mechanisms of action and affect the body in different ways. Since there is always a risk of undesirable consequences of taking, medications are prescribed only if the risk is justified. Side effects are associated with the mechanism of action of the drug, the method of excretion of the substance from the body, cumulative properties, a single effective dose of the drug, as well as individual characteristics of the patient’s body.
The latest drugs for hypertension usually have much less side effects compared to obsolete analogues, they are more effective. Due to the prolonged action, modern antihypertensive agents are usually used in lower doses, which significantly reduces the likelihood of side effects.
To prescribe adequate treatment, an examination is required, after which the doctor will prescribe a good medicine to the patient, which will be most effective in this case, in the optimal dosage, and the dose of the drug in milligrams (mg) per day and the number of doses per day are usually indicated. Some drugs can be purchased without a prescription in the pharmacy network, however, tablets from high blood pressure with the least side effects should be prescribed only by a qualified specialist, depending on the cause of the development of the pathological process, existing symptoms, the presence of complications, concomitant pathologies, the patient’s age and other parameters. In some cases, antihypertensive drugs are prescribed for life.
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.
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.
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).
Diuretic drugs, i.e. those with a diuretic effect, are often used for drug therapy of arterial hypertension. The mechanism of their action is to reduce the reabsorption of sodium ions in the renal tubules, which leads to an increase in the excretion of this trace element and a decrease in the amount of fluid in the body, causing a decrease in blood pressure.
The best modern diuretic drugs that are used with high blood pressure have the minimum number of possible side effects, which, when used correctly, usually do not take extreme forms.
Adverse effects when taking this group of drugs are usually observed if the dosage prescribed by the doctor is not observed. As a rule, diuretics are prescribed in combination with other drugs, already without a diuretic effect.
Preparations of this group – Furosemide, Indapamide, Hydrochlorothiazide, Clopamide.
The drugs act at different stages of the formation of angiotensin II. Some inhibit (suppress) the angiotensin-converting enzyme, others block the receptors that are affected by angiotensin II. The third group inhibits renin; it is represented by only one drug (aliskiren).
These drugs inhibit the transition of angiotensin I to active angiotensin II. As a result, the concentration of angiotensin II in the blood decreases, the vessels dilate, the pressure decreases. Representatives (synonyms are indicated in brackets – substances with the same chemical composition):
- Captopril (Kapoten) – dosage of 25 mg, 50 mg;
- Enalapril (Renitek, Burlipril, Renipril, Ednit, Enap, Enarenal, Enam) – dosage most often is 5 mg, 10 mg, 20 mg;
- Lisinopril (Diroton, Dapril, Lysigamma, Lisinoton) – the dosage is most often 5 mg, 10 mg, 20 mg;
- Perindopril (Prestarium A, Perineva) – Perindopril – dosage 2,5mg, 5mg, 10mg. Perineva – dosage of 4 mg, 8 mg .;
- Ramipril (Tritace, Amprilan, Hartil, Pyramil) – dosage of 2,5 mg, 5 mg, 10 mg;
- Hinapril (Akkupro) – 5 mg, 10 mg, 20 mg, 40 mg;
- Fosinopril (Fosicard, Monopril) – in a dosage of 10 mg, 20 mg;
- Trandolapril (Gopten) – 2 mg;
- Zofenopril (Zokardis) – dosage of 7,5 mg, 30 mg.
The drugs are available in different dosages for therapy with varying degrees of increase in blood pressure.
The peculiarity of Captopril (Kapoten) is that because of its short duration of action, it is rational only for hypertensive crises.
Bright representative of the group Enalapril and its synonyms are used very often. This drug does not differ in duration of action, therefore, take 2 times a day. In general, the full effect of ACE inhibitors can be observed after 1-2 weeks of drug use. In pharmacies, you can find a variety of generics (analogues) of enalapril, i.e.
ACE inhibitors cause a side effect – a dry cough. In cases of cough development, ACE inhibitors are replaced with drugs of another group. This group of drugs is contraindicated in pregnancy, has a teratogenic effect in the fetus!
These agents block angiotensin receptors. As a result, angiotensin II does not interact with them, the vessels dilate, blood pressure decreases
- Lozartan (Kozaar 50mg, 100mg; Lozap 12.5mg, 50mg, 100mg; Lorista 12,5mg, 25mg, 50mg, 100mg; Vazotens 50mg, 100mg);
- Eprosartan (Teveten) – 400 mg, 600 mg;
- Valsartan (Diovan 40mg, 80mg, 160mg, 320mg; Valsacor 80mg, 160mg, 320mg, Valz 40mg, 80mg, 160mg; Nortian 40mg, 80mg, 160mg; Valsafors 80mg, 160mg);
- Irbesartan (Aprovel) – 150mg, 300mg;
Candesartan (Atakand) – 8mg, 16mg, 32mg;
Telmisartan (Mikardis) – 40 mg, 80 mg;
Olmesartan (Kardosal) – 10mg, 20mg, 40mg.
Just like their predecessors, they allow you to evaluate the full effect 1-2 weeks after the start of administration. Do not cause dry cough. Should not be used during pregnancy! If pregnancy is detected during treatment, antihypertensive therapy with drugs of this group should be discontinued!
In arterial hypertension, angiotensin inhibitors can be used. This group includes angiotensin converting enzyme (ACE) inhibitors and angiotensin II receptor antagonists. These are effective drugs for pressure of a new generation without side effects in the case when they are correctly selected.
When ACE inhibitors inhibit the action of the angiotensin-converting enzyme, the production of angiotensin II decreases, which produces a vasoconstrictor effect. As a result, blood vessels dilate and blood pressure decreases. Possible side effects of angitensin inhibitors include too sharp and significant decrease in blood pressure (hypotension), headache, taste disturbances, poor appetite, muscle weakness, decreased hemoglobin concentration, white blood cell count, increased blood creatinine, proteinuria, allergic reactions.
Angiotensin II receptor antagonists inhibit the effects of angiotensin II on blood vessels, thereby lowering blood pressure. Side effects of these drugs include the development of an allergic reaction, nausea, dizziness, headache, kidney problems, drowsiness, pain in muscles and joints.
The drugs of this group are Lorista, Teveten, Vazotens.
Combination therapy: for or against?
Combined drugs combine several active substances of different effects on the body. Now there is no need to drink several tablets per day and calculate the time interval between receptions of medicines of different groups.
Instead of three tablets with a time interval, you can drink one – it is very convenient
In addition, during combination therapy with medications, the risk of various side effects is significantly reduced. The benefits of combination drugs are enough. Some of them include:
- The risk that the patient stops the recommended course of therapy due to the inconvenience of taking medications is reduced.
- Due to the fact that you need to take one drug, and not a large amount at once, money is saved.
- The components of drugs act on several organs at once and strengthen the whole body.
All these advantages can be felt only if you take the medicine regularly and do not miss the receptions. If used improperly, there will be no result.
These drugs are characterized in that they are able to protect not only the cardiovascular system, but also other organs from complications. The components of the preparations are combined in such a way that the effect on the body is complex.
At a time when a one-component medication is struggling with one problem, two or three component eliminates the negative effects from the heart, blood vessels, kidneys, liver, and also from the brain. The main indications for the use of combined funds:
- Normalization of the cardiovascular system;
- Restoration of blood circulation;
- Improving the condition of the vascular walls;
- Prevention of sudden spikes in blood pressure;
- Stimulation of brain cells;
- Lowering blood pressure.
Combination drugs for hypertension have different dosages of the active ingredients. This allows you to choose the most suitable tool for any form of the course of the disease.
Note. The active components of drugs act synchronously, enhance the effect of each other, and together neutralize side effects. This is another of the benefits of combination drugs.
All drugs in this group have two main components. The first with a hypotensive effect, the second has a diuretic property and enhances the effectiveness of the first.
Most often, hydrochlorothiazide acts as a diuretic, but another diuretic component can be used. The table shows the most popular and effective drugs.
|Drugs have the same active substance. They are available in different dosage forms, but are used for the same diseases – arterial hypertension and heart failure. Dosages depend on the stage of the disease, but most often prescribed 1 tablet 1 time per day. Doctors often recommend these medications not only for treatment, but also for the prevention of heart failure.|
|The drugs are similar and have the same active ingredients. Apply 1-2 times a day with arterial hypertension and heart failure. In addition, these drugs significantly reduce the risk of stroke, heart attack, and ischemia.|
|Antihypertensive drugs designed to treat any form of arterial hypertension. The dosage for adults is most often 1 tablet per day.|
|It is prescribed for hypertension 1-2 tablets per day (in the morning). Dosage depends on the complexity of the disease. The advantage of the medication is that it does not remove potassium from the patient’s body. Available in different dosages of active substances, which are selected individually.|
These drugs are well suited for hypertension accompanied by diabetes. The main indication is arterial hypertension. Also, in complex therapy, some medications can be prescribed for the treatment of angina pectoris.
Beta blockers with calcium antagonists – caring for the heart and normalizing blood pressure
In the composition of drugs, the same active substances, but different additional components. The selection of medicines is carried out by a cardiologist, based on the results of the analyzes. The table shows the most effective drugs in this group.
|The initial dosage of a half-tablet is 1 time per day, then the dose is increased to 1 tablet per day. If the disease is severe, then 2 tablets are prescribed. The closest analogue agent is Amlodak-AT.|
|Release form – tablets. Most often, doctors recommend taking one tablet per day, but with insufficient effectiveness, the dose can be increased to two tablets. Pills should be taken at the same time 30-40 minutes before meals.|
|The dosage form of the release is tablets on a blister. In addition to the antihypertensive effect, the drug has an antianginal property and restores the heart rate. Recommended dosages 1 tablet 1 time per day.|
|Expands vascular walls, lowers blood pressure, helps eliminate tachycardia, and also shows good results in the treatment of stable angina pectoris. As a rule, one tablet is taken per day (in the morning).|
As part of the preparations of this group, the same diuretic substance, but different blockers. The intake of these drugs should be strictly under the supervision of the attending physician, since they have a number of serious contraindications and can cause hypokalemia.
Hypokalemia – a low concentration of potassium ions in the blood
The most common drugs of this group can be found below in the table.
|It is used for arterial hypertension, as well as for the prevention of cardiovascular pathologies (if there is a genetic predisposition to these diseases). The recommended dose is 1 tablet/day.|
|Available in different dosages of the active ingredient. It is taken 1 or 2 r/day. The drug helps with arterial hypertension and reduces the risk of heart attack. The cheapest analogue of the drug is “Vazotens N”.|
|Available in tablet form, taken depending on the disease (1 or 2 tablets/day). Not prescribed for patients with acute renal and/or liver failure. It is used with caution in heart failure of a chronic or severe form. The most affordable analogues are Lozap, Ko-Centor.|
|Candesar N||Candesartan cilexetil|
|Most often, one tablet is taken once every 1 hours. The use of the pill does not depend on food intake, but it is better to use it at the same time in the morning.|
Important! Before taking combined pills for hypertension, you need to consult a doctor. Any of the above medicines has very serious contraindications and side effects.
If a patient with hypertension needs to be prescribed “chemical” tablets, then the doctor has the following choice:
- prescribe one medicine, and then, if necessary, increase its dose or replace it with another;
- immediately prescribe a combination drug that contains two active ingredients in low doses.
If a single drug is prescribed, then this is called hypertension monotherapy. Its advantage is that hypertension will not have to take extra medicine after the drug and its dosage are selected correctly. But guessing with the medicine the first time is rarely possible. Because it is impossible to predict the effectiveness of a particular medicine for a particular patient in advance. Over time, pharmacogenetics will give doctors this opportunity, but so far it is not.
If monotherapy is prescribed, then the patient with hypertension, together with his attending physician, has to change the drugs and their dosages several times. Because otherwise, blood pressure is not reduced enough. In such a situation, the vast majority of patients generally stop taking pills for pressure.
Popular combination medicines for hypertension
|Angiotensin II receptor blocker calcium antagonist|
|Triple combination Angiotensin II receptor blocker calcium antagonist diuretic|
|Angiotensin II receptor blocker thiazide diuretic|
|ACE inhibitor thiazide diuretic|
|ACE inhibitor dihydropyridine calcium antagonist|
|ACE inhibitor non-dihydropyridine calcium antagonist|
|Beta blocker dihydropyridine calcium antagonist|
|The rational combination of antihypertensive drugs||Indications for prescription|
|ACE inhibitor thiazide diuretic|
|ACE inhibitor calcium antagonist|
|Angiotensin-II receptor blocker thiazide diuretic|
|Angiotensin II receptor blocker calcium antagonist|
|Calcium antagonist thiazide diuretic|
|Calcium Antagonist Beta Blocker|
|Thiazide diuretic beta blocker|
Possible combinations of drugs for hypertension depending on concomitant diseases
|Clinical situation||Suitable Hypertension Medication Combinations|
|Left ventricular hypertrophy||BRA/IAPF with TD or AK|
|Asymptomatic atherosclerosis||BRA/IAPF with AK|
|Microalbuminuria||BRA/IAPF with TD|
|Myocardial Infarction||? -AB/AK with ARB/IAPF,? -AB with AK|
|Coronary heart disease||? -AB or AK with ARB or ACE inhibitor?|
|Chronic heart failure||ARB/ACE inhibitor with? -AB and TD|
|Chronic kidney disease/protein found in urine||ARB/ACE inhibitor with loop diuretic|
|Circulatory disorders in the legs||AK with BRA/IAPF|
|Elderly patients||BRA/IAPF with AK/TD|
|Isolated systolic hypertension||AK with TD; AK or TD with BRA/IAPF|
|Metabolic syndrome||BRA/IAPF with AK/TD|
|Diabetes||BRA/IAPF with AK/TD|
|Pregnancy||Methyldopa with AK /? – AB|
|Bronchial obstructive pathology||BRA with AK, BRA/AK with TD|
Explanations to the table:
TD – thiaz >
Official recommendations for the treatment of hypertension emphasize: preference should be given to tablets containing fixed combinations of 2-3 drugs under one shell. It is not advisable to prescribe 2-3 different types of tablets for simultaneous administration. Because the patient will get confused and will surely quit treatment.
Advantages of fixed combinations of drugs for hypertension:
- Such tablets contain rational combinations of drugs.
- This is the most effective strategy for lowering blood pressure and keeping it safe.
- The best protection of target organs: heart, kidneys, blood vessels, vision. A real reduction in the risk of heart attack and stroke.
- It is enough to take one tablet per day, so that patients are more likely to be treated.
All of the above means that the doctor should prescribe tablets with fixed combinations of drugs that lower blood pressure. There must be very good reasons to instead prescribe 2-3 different tablets for the patient to take at the same time. Such situations are very rare. For example, it is hypertension during pregnancy. The vast majority of cases of hypertension and concomitant diseases can be treated with fixed combinations.
Calcium channel blockers help relax the walls of blood vessels, making blood pressure lower. When using drugs of this group, undesirable effects are possible: dizziness, headache, acceleration of the heart rhythm, peripheral edema, dyspeptic disorders, bleeding gums, impaired gait, flushing of the skin of the face, increased appetite.
The drugs of this group are Adalat, Amlodipine, Thiazac, Verelan.
Calcium channel blockers (calcium antagonists) are a heterogeneous group of drugs that have the same mechanism of action, but differ in a number of properties, including pharmacokinetics, tissue selectivity, and the effect on heart rate. Another name for this group is calcium ion antagonists.
There are three main subgroups of AK: dihydropyridine (the main representative is nifedipine), phenylalkylamines (the main representative is verapamil) and benzothiazepines (the main representative is diltiazem). Recently, they began to be divided into two large groups depending on the effect on heart rate.
Diltiazem and verapamil are referred to as the so-called “rhythm-reducing” calcium antagonists (non-dihydropyridine). The other group (dihydropyridine) includes amlodipine, nifedipine and all other derivatives of dihydropyridine, increasing or not changing the heart rate. Calcium channel blockers are used for arterial hypertension, coronary heart disease (contraindicated in acute forms!) And arrhythmias. With arrhythmias, not all calcium channel blockers are used, but only pulsating.
- Verapamil 40mg, 80mg (prolonged: Isoptin SR, Verogalid EP) – dosage 240mg;
- Diltiazem 90mg (Altiazem PP) – dosage 180mg;
The following representatives (dihydropyridine derivatives) are not used for arrhythmias: Contraindicated in acute myocardial infarction and unstable angina.
- Nifedipine (Adalat, Cordaflex, Kordafen, Cordipin, Corinfar, Nifecard, Phenigidin) – dosage of 10 mg, 20 mg; Nifecard XL 30mg, 60mg.
- Amlodipine (Norvask, Normodipine, Tenox, Cordy Kor, Es Cordy Kor, Cardilopin, Kulchek,
- Amlotop, Omelarkardio, Amlovas) – dosage of 5 mg, 10 mg;
- Felodipine (Plendil, Felodip) – 2,5 mg, 5 mg, 10 mg;
- Nimodipine (Nimotop) – 30 mg;
- Lacidipine (Lacipil, Sakur) – 2 mg, 4 mg;
- Lercanidipine (Lerkamen) – 20mg.
Of the side effects of dihydropyridine derivatives, one can indicate edema, mainly lower extremities, headache, redness of the face, increased heart rate, increased frequency of urination. If the swelling persists, the drug must be replaced. Lerkamen, who is a representative of the third generation of calcium antagonists, due to the higher selectivity to slow calcium channels, causes swelling to a lesser extent than other representatives of this group.
Simultaneous administration of three drugs for hypertension
If the treatment regimen for hypertension of the two components does not help enough, then three drugs that reduce blood pressure are prescribed at the same time. Possible combinations are:
- ACE inhibitor dihydropyridine calcium antagonist beta-blocker;
- Angiotensin-II receptor blocker dihydropyridine calcium antagonist beta-blocker;
- ACE inhibitor calcium antagonist diuretic;
- Angiotensin-II receptor blocker calcium antagonist diuretic drug;
- ACE inhibitor diuretic beta-blocker;
- Angiotensin-II receptor blocker; diuretic beta-blocker;
- Dihydropyridine calcium antagonist diuretic beta-blocker.
If hypertension is not amenable to the action of powerful combination drugs or our proprietary treatment method without drugs, then the following should be done. Study the article “Causes of Hypertension and How to Eliminate Them”. Take blood and urine tests as written there. If a kidney or thyroid disease is found, treat it, because otherwise it will not be possible to take blood pressure under control.
Selective agonists of imidazoline receptors
Preparations of this group – Physiotens, Albarel.
What to do if the medicine lowers blood pressure too much
Many readers of our site take combination pills for pressure and, against this background, try the method of treating hypertension without drugs. After a few days, they discover that their pressure drops too low. As a result, weakness, drowsiness, dizziness, and other symptoms may occur, even fainting. In this case, it is time to abandon the “chemical” tablets, and to keep the pressure under control only with the help of natural remedies.
How to switch from combination drugs to the natural treatment of hypertension? It is not recommended to abolish “chemical” tablets sharply, in order to avoid ricochet increase in pressure. A combination medicine is one that contains 2-3 active substances. First stop taking the ingredient that causes the most side effects.
For this, you are likely to switch to monotherapy with combination pills. You wait 1-3 weeks, observe your pressure and well-being. Make sure that monotherapy plus natural remedies keep your blood pressure within normal limits. Only after that further reduce the dosage of drugs or completely abandon them.
Antispasmodic drugs affect the smooth muscles of blood vessels, causing them to expand, reduce blood viscosity, reduce stress on the heart, and moderately stimulate an increase in urine output. With their use, headache, dizziness, weakness and fatigue, loss of appetite, excessive sweating, heartburn, nausea, and a feeling of heat may occur.
The drugs of this group are Dibazol, Papaverine, No-shpa.
What medications for hypertension are the most harmful
What are the most harmful ingredients in combination hypertension medications? First of all, these are calcium antagonists. Because magnesium with vitamin B6 does the same thing, but 100% without harmful side effects. Forget about swelling, facial flushing, constipation, and other side effects of calcium antagonists! Instead, take magnesium with vitamin B6 in tablets, which are sold at any pharmacy. Your pressure will not only decrease, but your heart will also improve, your sleep will improve, and you will become calmer.
Magnesium tablets are a direct replacement for calcium antagonists. They are natural and safe, because magnesium and vitamin B6 are naturally present in the human body, participate in metabolism. Eliminate their deficiency – and your blood pressure will significantly decrease. Calcium antagonists are artificial molecules.
What other “chemical” drugs for hypertension are not recommended? First of all, these are diuretics hydrochlorothiazide (dichlothiazide) and chlortalidone, as well as beta-blockers. These are drugs that increase the level of uric acid in the blood, contribute to the development of diabetes and always worsen well-being. Use a drug-free hypertension treatment to say goodbye to harmful “chemical” pressure pills.
Complex drugs for pressure
It was found that certain combinations of substances mutually reinforce each other and therefore are more effective. So, combined preparations were created that contain several active substances in the optimal concentration and at the same time have a minimal amount of side effects.
This may be a combination of an angiotensin converting enzyme inhibitor and a diuretic, an angiotensin II receptor antagonist and a diuretic, a beta blocker and a calcium antagonist.
The advantages of such drugs also include the fact that instead of two drugs, you can take only one, they are suitable for people of advanced and senile (after 80 years) age.
In a number of complex medicines, the probability of negative effects on the body when used correctly is so low that they can practically be considered as new generation drugs without side effects.
The drugs of this group are Burlipril, Caposide, Tenochok, Gizaar, Mikardis plus.
We turn to the natural treatment of hypertension
Let’s take an example. Suppose a doctor has prescribed you Co-diovan for pressure and you have been taking it for a long time. This is a combination medicine for hypertension that contains valsartan and hydrochlorothiazide. Now you have tried the method of treating hypertension without medication and after a few days you have seen that it helps. The “upper” pressure is kept no higher than 120-130 mm Hg. Art. Well-being has improved significantly. What should I do with the pressure pills you have been prescribed?
We find out that valsartan belongs to the class of angiotensin-II receptor blockers. These drugs are well tolerated, rarely cause side effects. But hydrochlorothiazide is a thiazide diuretic, and it has significant side effects, which are described above. Therefore, first of all, you need to abandon it and watch how your body behaves. Go on to receive “pure” valsartan, which is sold under the names Diovan, Valz or Valsacor.
What class the medicine for pressure belongs to and what its trade names are – see
The transition period lasts 1-2 weeks. At this time, plan a minimum of loads and try not to be nervous. Carefully follow the recommendations of the method of treating hypertension without drugs. Just in case, read in advance how to stop a hypertensive crisis and keep the necessary funds on hand. Most likely, the transition period will go well.
Combination pills for hypertension contain low doses of drugs and nevertheless have a powerful effect on lowering blood pressure. They have a minimum of side effects. They are the most convenient for patients. In most cases, drugs with fixed combinations can and should be prescribed – those that contain 2-3 active substances in one tablet.
The invention of tablets for hypertension – fixed combinations – significantly increased the effectiveness of treatment. This increased the average life expectancy of patients by several years. However, our proprietary non-drug treatment for hypertension is even better. Because it is 100% without harmful side effects, and at the same time inhibits other age-related diseases – obesity, atherosclerosis and joint problems. In middle and old age you will have excellent health, the envy of peers.