What drugs are used to treat high blood pressure?
Hypertension: Drugs used to treat hypertension. Diuretics. There are three classes of diuretic drugs that are used to treat hypertension. Most commonly used are thiazide diuretics such as hydrochlorothiazide or chlorthalidone.
When are antihypertensive medications indicated in the treatment of hypertension (high blood pressure)?
In patients with stage 1 HTN, recommendations are to start antihypertensive medications if the patient has a 10-year ASCVD risk of 10% or higher with a target of BP less than 130/80 to prevent patients from cardiovascular events.
What is the first line of treatment for hypertension (high blood pressure)?
For this reason, the Joint National Commission on Hypertension Detection Evaluation and Treatment (JNCVII) recommended thiazide diuretics as first line therapy for patients with hypertension, unless there were special reasons to select another type of drug.
What is resistant hypertension and how is it treated?
Treatment for specific situations. Resistant hypertension refers to blood pressure that remains high after trying at least three different types of blood pressure medication. Someone whose high blood pressure is controlled by taking four different kinds of medication is considered to have resistant hypertension.
What are the four major modes of treatment for hypertension?
Medications used to treat high blood pressure include:Diuretics. Diuretics, sometimes called water pills, are medications that help your kidneys eliminate sodium and water from the body. ... Angiotensin-converting enzyme (ACE) inhibitors. ... Angiotensin II receptor blockers (ARBs). ... Calcium channel blockers.
What are 3 ways to treat hypertension?
Eating a diet that is rich in whole grains, fruits, vegetables and low-fat dairy products and skimps on saturated fat and cholesterol can lower your blood pressure by up to 11 mm Hg if you have high blood pressure. This eating plan is known as the Dietary Approaches to Stop Hypertension (DASH) diet.
Which of the following are used in treatment of hypertension?
There are several types of drugs used to treat high blood pressure, including: Angiotensin-converting enzyme (ACE) inhibitors. Angiotensin II receptor blockers (ARBs) Diuretics.
Which hypertension is not treatable?
Resistant hypertension is high blood pressure that does not respond well to aggressive medical treatment. Hypertension is considered resistant when all of the following are true: Someone is taking three* different blood pressure medications at their maximally tolerated doses.
What is the first line treatment for hypertension?
There are three main classes of medication that are usually in the first line of treatment for hypertension: 1. Calcium Channel Blockers (CCB) 2. Angiotensin Converting Enzyme inhibitors (ACE inhibitors or ACE-I) and Angiotensin Receptor Blockers (ARBs) 3. Diuretics.
What are the 4 stages of hypertension?
High blood pressure is classified in one of several categories — and those designations can influence treatment. Doctors classify blood pressure into four categories: normal, prehypertension (mild), stage 1 (moderate) and stage 2 (severe).
How is hypertension managed?
First-line medications used in the treatment of hypertension include diuretics, angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs), beta-blockers, and calcium channel blockers (CCBs). Some patients will require 2 or more antihypertensive medications to achieve their BP target.
Which of the following classes of antihypertensive drugs is not recommended for initial treatment?
Nondihydropyridine calcium channel blockers (CCBs) are not recommended in the treatment of hypertension in adults with HFrEF.
What is the most common hypertension medication?
The most common high blood pressure medications by total prescriptions written include:Lisinopril (Prinivil, Zestril): This medication is an angiotensin-converting enzyme (ACE) inhibitor. ... Metoprolol (Lopressor, Toprol XL): This medication is a beta-blocker.More items...
Why is hypertension not controlled?
The major causes of uncontrolled hypertension are inadequate therapy, patient noncompliance and inappropriate therapy.
What is the most common reason for treatment failure of hypertension?
Treatment resistance can be attributed to poor adherence to antihypertensive drugs, excessive salt intake, physician inertia, inappropriate or inadequate medication, and secondary hypertension.
What causes treatment resistant hypertension?
Most common secondary causes of resistant hypertension are obstructive sleep apnea, renal artery stenosis, renal parenchymal disease, and primary aldosteronism while some uncommon causes such as pheochromocytoma, Cushing's disease, thyroid and parathyroid dysfunction; and aortic coarctation also contribute to resistant ...
How to stop high blood pressure?
Try the Dietary Approaches to Stop Hypertension (DASH) diet, which emphasizes fruits, vegetables, whole grains, poultry, fish and low-fat dairy foods. Get plenty of potassium, which can help prevent and control high blood pressure. Eat less saturated fat and trans fat. Decrease the salt in your diet.
Why do doctors take blood pressure readings?
Because blood pressure normally varies during the day and may increase during a doctor visit (white coat hypertension), your doctor will likely take several blood pressure readings at three or more separate appointments before diagnosing you with high blood pressure.
What is elevated blood pressure?
Elevated blood pressure is a systolic pressure ranging from 120 to 129 mm Hg and a diastolic pressure below (not above) 80 mm Hg. Elevated blood pressure tends to get worse over time unless steps are taken to control blood pressure. Elevated blood pressure may also be called prehypertension. Stage 1 hypertension.
What are Alpha blockers?
Alpha blockers include doxazosin (Cardura), prazosin (Minipress) and others. Alpha-beta blockers. Alpha-beta blockers block nerve signals to blood vessels and slow the heartbeat to reduce the amount of blood that must be pumped through the vessels.
What does blood pressure measure?
A blood pressure reading, as shown in the blood pressure monitor in the image, measures the pressure in your arteries when your heart beats (systolic pressure) in the first number, and the pressure in your arteries between heartbeats (diastolic pressure) in the second number.
What happens if your blood pressure is high?
If your blood pressure remains stubbornly high despite taking at least three different types of high blood pressure drugs, one of which usually should be a diuretic, you may have resistant hypertension.
What tests are done to confirm if you have high blood pressure?
Ambulatory monitoring. This 24-hour blood pressure monitoring test is used to confirm if you have high blood pressure.
What is the best way to reduce blood pressure?
Diuretics . Diuretics , sometimes called water pills, help the kidneys get rid of excess water and salt (sodium). This reduces the volume of blood that needs to pass through the blood vessels. As a result, blood pressure goes down. There are three major types of diuretics defined by how they work.
What is resistant hypertension?
Resistant hypertension refers to blood pressure that remains high after trying at least three different types of blood pressure medication. Someone whose high blood pressure is controlled by taking four different kinds of medication is considered to have resistant hypertension.
How does catecholamine affect blood pressure?
The muscles around some blood vessels have what are known as alpha-1 or alpha adrenergic receptors. When a catecholamine binds to an alpha-1 receptor, the muscle contracts, the blood vessel narrows, and blood pressure rises.
How to make the most of your treatment?
To make the most of your treatment, it’s vital to get regular medical checkups and blood pressure tests. Regular checkups allow your doctor to monitor how well your treatment is going and make any necessary adjustments to your treatment plan.
What is considered high blood pressure?
The goal is to get your blood pressure below the high range. If normal is less than 120/80 mm Hg, what’s high? When the systolic blood pressure — the top number — is between 120 and 129, and the diastolic blood pressure — the bottom number — is less than 80, this is considered elevated blood pressure.
What is the effect of ARBs on blood pressure?
ARBs block the action of angiotensin II directly on the blood vessels. It attaches at the receptor site on the blood vessels and keeps them from narrowing. This causes blood pressure to fall.
How does ACE inhibitor work?
ACE inhibitors help the body produce less of a hormone called angiotensin II, which causes blood vessels to narrow. These medications decrease blood pressure by helping blood vessels expand and let more blood through.
What is the HTN stage?
The 2017 American College of Cardiology (ACC) and American Heart Association (AHA) definition of HTN stages is: Normal blood pressure (BP): systolic BP is less than 120, and diastolic BP is less than 80. Elevated BP: systolic BP 120 to 130 ...
What is the target BP for kidney disease?
In patients with chronic kidney disease, the target BP is 130/80. For patients with type 2 diabetes mellitus (T2DM), it is recommended to start on antihypertensive medications if BP is more than 130/80 with a goal of BP lower than 130/80.
Which is better, chlorthalidone or doxazosin mesylate?
Chlorthalidone, when compared with doxazosin mesylate, was better in preventing cardiovascular disease, when compared with lisinopril was found to be better in preventing cardiovascular disease, including strokes and heart failure incidence, and when compared with amlodipine was better in preventing heart failure.
How do beta blockers work?
Beta-blockers work by inhibiting the catecholamines from binding to the Beta 1,2, and 3 receptors. Beta-1 receptors are found primarily in the heart muscle, beta-2 receptors are located in the bronchial and peripheral vascular smooth muscles, and beta-3 receptors appear in adipose tissue of the heart.
Does hydrochlorothiazide lower blood pressure?
Switching to chlorthalidone from hydrochlorothiazide decreases systolic blood pressure by 7 to 8 mm Hg.
Is chlorthalidone better than hydrochlorothiazide?
They are better at decreasing the risk of cardiovascular disease comparing to hydrochlorothiazide. [4][5] Chlorthalidone is the drug of choice to start as monotherapy for hypertension. Studies show it to be the best diuretic to control blood pressure and to prevent mortality and morbidity.
Is spironolactone a good antihypertensive?
Spironolactone is superior to doxazosin and bisoprolol in lowering blood pressure when added to first-line antihypertensive agents in treating resistant hypertension. [28] Hydralazine can be added for the treatment of resistant hypertension, either alone or in combination with nitrates, in case of heart failure.
Interactions
- Diuretics increase the effectiveness or all other classes of antihypertensive agents. Therefore, almost any subject, except those with a contraindication, should receive a diuretic if their blood pressure requires more than one drug for its management.
Adverse effects
- Adverse Effects: Diuretics increase the excretion of potassium and can lead to hypokalemia (low blood potassium concentration) which predisposes to irregular heart beats, and muscular weakness. However, a combination of a thiazide or loop diuretic with a distal, potassium sparing agent (such as in the combined medications, Maxzide or Moduretic), prevents potassium loss a…
Types
- Different Drugs: Thiazide diuretics include: hydrochlorothiazide (usual starting dose 12.5 to 25 mg daily) or chlorthalidone (similar dose range). Loop diuretics include: furosemide (Lasix), bumetanide (Bumex), and torsemide (Demadex), torsemide has a rather longer duration and is preferred in patients with heart failure. Ethacrinic acid (Edecrin) is used in the rare patients who …
Medical uses
- ACEIs are widely used to treat hypertension because they are effective, have relatively few side effects and in reduce the complications of hypertension such as heart attacks and strokes. They have a special use in patients with diabetes mellitus who have protein the urine (diabetic nephropathy) and in patients with chronic kidney disease (CKD) in whom they appeared to have …
Examples
- Individual Drugs: The following are examples of ACEIs in clinical practice: benazepril (Mylan), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), Lisinopril (Prinivil), moexipril (Univasc), quinapril (Accupril), ramipril (Altace) and trandolapril (Mavik). There are some small differences in how long these drugs act in the circulation, they are relatively small and, with the e…
Side effects
- Biochemical changes with ACEIs are usually insignificant in patients with normal kidney function. However, in those with impaired kidneys, they can raise the serum potassium concentration to levels that are dangerous and require either a change in therapy, or increasing thiazide or loop diuretic dosage to promote potassium loss. Such patients should discuss with their physician o…
Contraindications
- Special Indications: As these include patients with chronic kidney disease (but see the adverse effects above), early diabetes mellitus, congestive heart failure, or left ventricular hypertrophy. These drugs will not be discussed in detail since they are used infrequently.
Mechanism of action
- This group of drugs was introduced next after diuretics, to be used for hypertension. They act on a part of the nervous system that controls blood pressure, known as the sympathetic nervous system. Blockade of the sympathetic nervous system reduces blood pressure by relaxing blood vessels, and decreasing the rate and force of contraction of the heart. Therefore, beta blockers a…
Pharmacology
- The actions of these agents are enhanced in patients taking diuretic drugs and therefore are a good second or third line selection in those patients who are not controlled with a diuretic and an ACEI or ARB. Unfortunately, alpha blockers have been shown to be less affective than other groups of blood pressure lowering agents in preventing the complications of heart failure and he…
Categories
- Individual drugs: They fall into two categories. The first are called dihydropyridine CCBs and include amlodipine (Norvasc), felodipine (Plendil), nifedipine (Procardia), and nicardipine (Cardene). The second, termed nondihydropyridine CCBs include two drugs, diltiazem (Dilacor, Cardizem, Cartia, and Tiazac), and verapamil (Calan, Covera, Isoptin, Verelan). Both groups are e…
Effects
- Non-dihydropyridine CCBs cause cardiac slowing. This typically reduces the heart rate by about 10%. It can be beneficial in some patients with a fast heart rate or who have irregular heartbeat (atrial fibrillation), but in those with a slow initial heart rate, it can cause symptoms of decreased cardiac output (tiredness, lethargy, and dizziness on exertion). This group of drugs also can cau…
Research
- This is a rapidly developing field with extensive research, both by Centre scientists in the laboratory and clinical investigators in patients with hypertension. The following outlines some of the areas of research conducted at the Centre at Georgetown. Research at the Hypertension, Kidney and Vascular Research Centre at Georgetown has focused on a different path, namely dr…
Pathophysiology
- Oxidative stress occurs in cells and tissues of the body when oxygen reacts to form toxic molecules called reactive oxygen species (ROS). These can inactivate the normal signaling pathways between cells, damage cell membranes and proteins, and alter the DNA that forms the basis of our genes. Therefore, oxidative stress has widespread effects in the body. Increasing ev…
Cause
- Amongst those factors that are under our control which influence the probability of developing hypertension, an excessive dietary salt intake is probably the most important. Research in animal models at Georgetown at the Center for Hypertension, Kidney, and Vascular Research has linked dietary salt intake with oxidative stress that may underlie the hypertension and adverse consequ…
Resources
- For further information about how to support the research in Georgetown Universitys Center for Hypertension, Kidney, and Vascular Research, please see Georgetown Universitys Office of Advancement.
Diagnosis
Treatment
- Changing your lifestyle can help control and manage high blood pressure. Your doctor may recommend that you make lifestyle changes including: 1. Eating a heart-healthy diet with less salt 2. Getting regular physical activity 3. Maintaining a healthy weight or losing weight if you're overweight or obese 4. Limiting the amount of alcohol you drink But sometimes lifestyle change…
Clinical Trials
- Explore Mayo Clinic studiestesting new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.
Lifestyle and Home Remedies
- Lifestyle changes can help you control and prevent high blood pressure, even if you're taking blood pressure medication. Here's what you can do: 1. Eat healthy foods.Eat a heart-healthy diet. Try the Dietary Approaches to Stop Hypertension (DASH) diet, which emphasizes fruits, vegetables, whole grains, poultry, fish and low-fat dairy foods. Get ple...
Alternative Medicine
- Although diet and exercise are the most appropriate tactics to lower your blood pressure, some supplements also may help lower it. However, more research is needed to determine the potential benefits. These supplements include: 1. Fiber, such as blond psyllium and wheat bran 2. Minerals, such as magnesium, calcium and potassium 3. Folic acid 4. Supplements or products that incre…
Coping and Support
- High blood pressure isn't a problem that you can treat and then ignore. It's a condition you need to manage for the rest of your life. To keep your blood pressure under control: 1. Take your medications properly.If side effects or costs pose problems, don't stop taking your medications. Ask your doctor about other options. 2. Schedule regular doctor visits.It takes a team effort to tr…
Preparing For Your Appointment
- If you think you may have high blood pressure, make an appointment with your doctor to have your blood pressure checked. No special preparations are necessary to have your blood pressure checked. You might want to wear a short-sleeved shirt to your appointment so that the blood pressure cuff can fit around your arm properly. Avoid eating, drinking caffeinated beverages an…