Sunday, May 26, 2019

Treating High Blood Pressure with Medication

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If lifestyle changes alone do not lower your blood pressure to a healthy level, your doctor will want you to try medications. Many things determine what drug you’ll be prescribed, including your age, racial and genetic background, presence or absence of damage to your kidneys and other organs, the risk of side effects, and the presence of other diseases.

No single medicine is ideal for all people. Drugs differ in the way they lower blood pressure and, depending on each person’s characteristics, in their potential for unwanted side effects. If the first drug or drug dose you try does not work, your doctor will change the dose or the drug. This is not unusual, so don’t be discouraged. It’s hard to predict who will respond to particular medicines. Work with your doctor until you find the right medicines for you.

If your blood pressure is severely elevated, you may need to be hospitalized and given intravenous medicine while your blood pressure, heart rhythm and rate are monitored.

For People Over 60

Doctors once believed that it was of no benefit to treat high blood pressure in people over age 60, and that treatment might even be harmful. The theory was that older people needed a higher blood pressure because their arteries were stiffer. Some doctors feared that lowering the blood pressure to levels that were normal in younger people might cause strokes or kidney failure.

A wealth of research now shows that people over 60 get just as much benefit, if not more, from having their high blood pressure treated. Proper treatment reduces the risk of major diseases in people over 60:

Risk of stroke reduced by 35 percent
Risk of coronary heart disease reduced by 20 percent
Risk of premature death from blood-vessel disease reduced by 20 percent

For African-Americans

African-Americans generally respond best to blood- pressure medicines in one of three groups: diuretics, calcium channel blockers, and combination alpha and beta-blockers. Beta-blockers and ACE inhibitors are somewhat less powerful in African-Americans unless combined with diuretics.

Reduce Your Pill Bill

Some of the most effective blood pressure drugs are quite inexpensive. Learn how you can contain costs, while still using effective medicines.

Master Your Medications

Because high blood pressure medication generally needs to be taken indefinitely, cost, convenience and tolerance are extremely important in deciding on the best treatment regimen for you. Blood pressure medications are grouped into different categories, or classes, which work in different ways. Learn all about the different drug classes and drugs in our chart.

Blood-Pressure Medications Chart

Because high-blood-pressure medication generally needs to be taken indefinitely, cost, convenience and tolerance are extremely important in deciding on the best treatment regimen for you. Every medication works better when accompanied by lifestyle changes.

Blood-pressure medications are grouped into different categories, or classes, which work in different ways. For information on the different drug classes classes and the most commonly used drugs in each class, refer to the chart below.

Blood Pressure Medications
Type Of Drug Examples Generic name first, followed by brand name(s) in parentheses. What These Drugs Do
Thiazide diuretics chlorothiazide (Aldoclor, Diupres, Diuril) chlorthalidone (Hygroton) hydrochlorothiazide (Esidrix, HydroDIURIL, Microzide) indapamide (Lozol) metolazone (Mykrox, Zaroxolyn) Reduce the amount of blood fluid. Cause the kidneys to increase the salt and water that are passed in the urine, thereby lowering the amount of blood fluid and, as a result, lowering the blood pressure. Cause a loss of potassium from the body.
Loop diuretics bumetanide (Bumex) ethacrynic Acid (Edecrin) furosemide (Lasix) torsemide (Demadex) Reduce the amount of blood fluid. Cause the kidneys to increase the salt and water that are passed in the urine, thereby lowering the amount of blood fluid and, as a result, lowering the blood pressure. Cause a loss of potassium from the body.
Potassium-sparing diuretics amiloride (Midamor) spironolactone (Aldactone) triamterene (Dyrenium) Reduce the amount of blood fluid. Cause the kidneys to increase the salt and water that are passed in the urine, thereby lowering the amount of blood fluid and, as a result, lowering the blood pressure. Do not cause a loss of potassium from the body.
Beta-blockers, cardioselective acebutolol (Sectral) atenolol (Tenormin) betaxolol (Kerlone) bisoprolol (Zebeta) metoprolol succinate (Toprol-XL) metoprolol tartrate (Lopressor) Reduce the work of the heart. Block the stimulating effects of the hormones epinephrine and norepinephrine on the heart, causing the heart to work less hard and pump less frequently.
Beta-blockers, nonselective timolol (Blocadren) nadolol (Corgard) pindolol (Visken) propranolol (Inderal) Block the tightening effects of the hormones epinephrine and norepinephrine on blood vessels throughout the body. Block the stimulating effects of the same hormones on the heart, causing the heart to work less hard and pump less frequently.
Alpha-1 blockers prazosin (Minipress) terazosin (Hytrin) doxazosin (Cardura) Widen the small arteries. Make the blood vessels less sensitive to the effects of norepinephrine, a hormone that narrows arteries.
Medications that act on the brain (centrally acting blood pressure medications) clonidine (Catapres) methyldopa (Aldomet) guanabenz (Wytensin) Widen the blood vessels. Enhance the brain’s ability to control whether the small arteries widen or narrow, using signals that it sends through nerves.
Both alpha- and beta-blockers carvedilol (Coreg) doxazosin (Cardura) labetalol (Normodyne, Trandate) Widen the small arteries and reduce the work of the heart. Block the tightening effects of the hormones epinephrine and norepinephrine on blood vessels throughout the body. Block the stimulating effects of the same hormones on the heart, causing the heart to work less hard and pump less frequently.
Peripheral nerve agents guanethidine (Ismelin) reserpine (Serpasil) Widen the small arteries by influencing nerve signals. (Normally, the brain can control whether the small arteries widen or narrow, using signals that it sends through nerves.)
Angiotensin-converting enzyme (ACE) inhibitors benazepril (Lotensin) captopril (Capoten) enalapril (Vasotec) fosinopril (Monopril) lisinopril (Prinivil, Zestril) moexipril (Univasc) perindopril (Aceon) quinapril (Accupril) ramipril (Altace) trandolapril (Mavik) Widen the small arteries and reduce the amount of blood fluid by blocking the production of the hormone angiotensin II.
Angiotensin II receptor blockers candesartan (Atacand) eprosartan (Teveten) irbesartan (Avapro) losartan (Cozaar) telmisartan (Micardis) valsartan (Diovan) Widen the small arteries and reduce the amount of blood fluid by blocking the action of the hormone angiotensin II.
Blood vessel openers (direct vasodilators) hydralazine (Apresoline) minoxidil (Loniten) Widen the small arteries through direct effects on the muscle in the wall of the small arteries.
Calcium channel blockers amlodipine (Norvasc) isradipine (DynaCirc) nicardipine (Cardene) nifedipine (Adalat, Procardia) nimodipine (Nimotop) nisoldipine (Sular) felodipine (Plendil) diltiazem (Cardizem, Dilacor, Tiazac) verapamil (Calan, Isoptin, Verelan) Widen the small arteries by blocking calcium entry into the muscle in the wall of the small arteries.

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Jonathan
Medically trained in the UK. Writes on the subjects of injuries, healthcare and medicine. Contact me [email protected]

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