Each category of antihypertensive drugs acts by regulating one of these processes to control the increase in blood pressure. Diuretics: Drain out excess sodium and water from your body. Anti-adrenergics: Act on either the alpha or beta type of receptors and are accordingly called alpha blockers or beta blockers.
What medications are used for hypertension?
- Alpha blockers. Alpha blockers prevent the hormone norepinephrine (noradrenaline) from tightening the muscles in the walls of smaller arteries and veins, which causes the vessels to remain open and relaxed.
- Alpha-beta blockers. Alpha-beta blockers work similarly to beta blockers. ...
- Central-acting agents. ...
- Vasodilators. ...
- Aldosterone antagonists. ...
What is the best blood pressure medication?
You may be given one or more of these medications:
- Water pills (diuretics). A diuretic removes excess water and sodium from the body, so there's less fluid flowing through the veins and arteries. ...
- Angiotensin-converting enzyme (ACE) inhibitors. ...
- Angiotensin 2 receptor blockers (ARBs). ...
- Calcium channel blockers. ...
- Beta blockers. ...
- Renin inhibitors. ...
What are some antihypertensive drugs?
Some antihypertensive drugs, most notably beta-blockers, depress heart rate and contractility (this decreases stroke volume) by blocking the influence of sympathetic nerves on the heart. Calcium-channel blockers, especially those (non-dihydropyridines) that are more cardioselective, also reduce cardiac output by decreasing heart rate and ...
What is first line therapy for hypertension?
Pharmacotherapy Drug therapy is needed if lifestyle modifications cannot adequately bring BP to goal. 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).
How does hypertensive medication work?
Blood pressure medicines can keep blood pressure at a healthy level by1: Causing your body to get rid of water, which decreases the amount of water and salt in your body to a healthy level. Relaxing your blood vessels. Making your heart beat with less force.
What is the role of antihypertensive drugs on the action of the heart?
Some antihypertensive drugs, most notably beta-blockers, depress heart rate and contractility (this decreases stroke volume) by blocking the influence of sympathetic nerves on the heart.
Does antihypertensive drugs lower blood pressure?
Many blood pressure medications, known as antihypertensives, are available by prescription to lower high blood pressure (HBP or hypertension). There are a variety of classes of high blood pressure medications and they include a number of different drugs.
How do centrally acting antihypertensives work?
Central-acting agents lower heart rate and reduce blood pressure. The medicine blocks signals from the brain to the nervous system that increase the heart rate and narrow blood vessels. As a result, the heart doesn't pump as hard and blood flows more easily through the body's veins and arteries.
What is the first line drug of choice 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.
Do antihypertensives reduce heart rate?
As a result of effects on central blood pressure, studies in which beta-blockers are compared to antihypertensives, which also lower heart rate, may be more likely to report similar outcomes, whereas beta-blockers may have increased cardiovascular event rates when compared to antihypertensive regimens that do not lower ...
How long do antihypertensives take to work?
Our meta-analysis demonstrates that estimation of maximal effect could be made between 1 and 2 weeks after initiation of antihypertensive therapy, although drug class effects on speed of titration are not predictable.
What are the benefits of antihypertensives?
What are the advantages of antihypertensives? Blood pressure medications help many people lower their high blood pressure and keep their hearts from becoming overworked. They also help people avoid having heart failure, kidney failure, a heart attack or stroke.
What are the risks of antihypertensives?
However, antihypertensive treatments were associated with an increased risk for four of six secondary outcomes — acute kidney injury (15 studies; odds ratio, 1.18), hyperkalemia (26 trials; OR, 1.89), hypotension (35 trials; OR, 1.97), and syncope (16 trials; OR, 1.28).
What are the 4 classes of antihypertensive drugs?
The four major classes of antihypertensive drugs—diuretics, β-blockers, calcium channel blockers, and renin-angiotensin system inhibitors (including angiotensin-converting enzyme inhibitors and angiotensin receptor blockers)—have significant qualitative and quantitative differences in the adverse effects they cause.
Which antihypertensive works fastest?
Nifedipine and captopril are the two agents with the most rapid onset, within 0.5-1 hour, and may treat hypertensive emergencies as well as urgencies. Clonidine and labetalol have maximal blood pressure lowering effects at 2-4 hours.
What are the three classes of antihypertensive drugs?
Diuretics, adrenergic inhibitors, and vasodilators--the three major classes of drugs used in the treatment of hypertension--have an impact on coronary heart disease.
Which drug has antihypertensive action?
Diuretics. Thiazide (bendroflumethiazide, hydrochlorothiazide) and thiazide-like (chlortalidone, indapamide) diuretics are the most commonly prescribed diuretic agents used to treat hypertension.
What are the side effects of antihypertensive drugs?
Some common side effects of high blood pressure medicines include:Cough.Diarrhea or constipation.Dizziness or lightheadedness.Erection problems.Feeling nervous.Feeling tired, weak, drowsy, or a lack of energy.Headache.Nausea or vomiting.More items...•
Which are the antihypertensive drugs?
There are multiple classes of antihypertensive medications used for the treatment of HTN; the most recommended classes used as first-line for treatment are: Thiazide-type diuretics. Calcium channel blockers. Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs)
Which of the following drugs acts as antihypertensive?
Centrally acting antihypertensive drugs, like methyldopa and clonidine, act by stimulation of alpha 2 adrenoceptors in the central nervous system which results in a reduction in sympathetic tone and a fall in blood pressure. Methyldopa may be used for the management of hypertension in pregnancy.
What is the purpose of antihypertensives?
Answer: Anti-hypertensives are medicines used to lower high blood pressure. In the long term, uncontrolled high blood pressure can damage the blood vessels of the brain, heart and kidneys – causing stroke, heart failure or kidney failure.
When are antihypertensives prescribed?
Anti-hypertensives are usually prescribed when other therapies such as diet modification and exercise do not work. There are several types of anti-hypertensive drugs and they work in different ways.
What is the effect of calcium channel blockers on the heart?
Calcium channel blockers block the entry of calcium into the muscle cells of the heart and arteries, thu s causing the blood vessels to dilate
How does ACE inhibitor work?
ACE inhibitors help to relax blood vessels by blocking an enzyme in the body which is needed to produce a substance that causes blood vessels to contract
Can you stop blood pressure medication without a doctor?
More importantly, never stop your medication without consulting your doctor, even if your blood pressure is lowered. Ask the Expert is where we answer questions on all aspects of your health and wellness. Send in your health-related questions to [email protected].
How do antihypertensive drugs affect the kidney?
These actions are of two main kinds: dilatation of the afferent arteriole, and inhibition of solute uptake from the renal tubule. Both actions change the hydrostatic pressure profile along the renal blood vessels , the first by changing vascular tone and the second by rebalancing the contributions to the Starling forces made by hydrostatic and osmotic pressures driving reabsorption. Some drugs show both modes of action. The actions of antihypertensive drugs elsewhere on the body are sometimes beneficial and often adverse; these actions may be less relevant to their effects on lowering blood pressure in the long-term, but much attention is paid to these incidental effects in the literature.
How does a vasoactive drug affect the kidney?
Perhaps the simplest way for a vasoactive drug to permit the kidney to perform its normal handling of salt and water at a reduced MAP is via dilatation of the afferent arteriole leading to the glomerulus. Isolated afferent arteriolar vasodilatation could allow the glomerular capillaries to be perfused at an unchanged pressure in the presence of a low MAP. This could maintain an unchanged glomerular filtration rate (GFR) and an unchanged renal blood flow (RBF), whilst a measurement of renal vascular resistance (if defined as MAP/RBF) would show it to have decreased. Such an intervention would be analogous to the surgical removal of a renal artery stenosis, a classic example of “secondary hypertension,” eliminating an excessive pressure drop across the vessels entering the kidney, so that from the glomerular capillaries onwards nothing is different after the intervention when compared with before the intervention. It will become clear that the actions of several families of drugs converge on this common pathway.
What is the long term regulation of arterial blood pressure?
The long-term regulation of systemic arterial blood pressure is a topic beset with a remarkable degree of controversy. Many textbooks teach that systemic vascular resistance ( SVR) is the primary factor in this long-term regulation ( Pocock and Richards, 2006; Levick, 2010; Beevers et al., 2014 ), a view that continues to be aired in peer-reviewed scientific journals ( Averina et al., 2012; Pettersen et al., 2014; Kurtz et al., 2015; Joyner et al., 2016 ). Some texts highlight the role of the kidney in setting arterial blood pressure, emphasizing its role in determining the volume of fluid in the circulation ( Boron and Boulpaep, 2012; Mohrman and Heller, 2014 ). Sometimes these discordant viewpoints are presented one following another without resolution ( Steddon et al., 2007 ). The confusion associated with this topic is important because extensive resources are directed toward the diagnosis and treatment of hypertension, since sustained elevation of arterial blood pressure makes a very considerable and geographically variable contribution to the global burden of mortality from non-communicable diseases ( Forouzanfar et al., 2015 ). Thus, for example, a recent comparison between the USA, Canada and England has shown high prevalences of hypertension, a strong relationship between indicators of hypertension and both stroke mortality and ischemic heart disease mortality, and rather dramatic differences between these three countries ( Joffres et al., 2013 ). Recognition and management of hypertension appear to be strongest in Canada, followed by the USA, followed by particularly alarming figures for England. Given that the therapeutic activity of antihypertensive drugs is to a large extent empirical and may itself be associated with a variety of adverse effects, clear targeting of relevant tissue components in whatever organ system does regulate arterial pressure over long periods of time, would be highly desirable.
What is the main regulated route for excretion of salt and water?
Over prolonged periods of time the inputs of salt and water to the circulation must match their output. Since the kidney provides the main regulated route for excretion of salt and water, the pressure in the arterial tree must equilibrate over time with the pressure required by the kidney to perform this ongoing task.
Why do AR blockers have different action?
A question arises as to why the AR blockers appear to have a somewhat different action on the renal vascular pressure profile from the ACE inhibitors, given that both agents diminish the action of angiotensin II. At least three factors seem material: the AR blockers act on only one of the two main angiotensin receptors, angiotensin II is formed in part by non-ACE pathways, and ACE is responsible for breaking down bradykinin—an endogenous dilator that augments renal blood flow ( Epstein and Gums, 2005 ).
Is arterial blood pressure variable?
A considerable variability of arterial blood pressure obtained from one measurement to another over short periods of time is widely observed in patients and healthy individuals, even at rest ( Littler et al., 1978; deBoer et al., 1987; Rothwell, 2010 ). Perhaps more than physicians in any other specialty, anesthetists are familiar with exaggerations of normal changes; it is not uncommon to see the rapid halving or doubling of arterial blood pressure in response to drugs such as anesthetics, vasodilators, and catecholamines, as well as to surgical events. Short-term lability of blood pressure can be thought of as resulting from rapid changes in SVR, vascular compliance, cardiac contractility, heart rate, and (in the presence of bleeding or infusion) circulating volume. The interplay of these factors, when precisely defined, enables MAP to be modeled in what might be regarded as a closed circulation ( Dorrington and Pandit, 2009; Keener and Sneyd, 2009 ).
Is CVP a determinant of MAP?
Equation (1) inclines us to think in terms of MAP as being almost mathematically proportional to SVR, and hence to consider SVR as being a major determinant of MAP. The common usage that variables on the left-hand side of an equation are dependent variables, whilst those on the right-hand side are independent variables, has tended to reinforce this emphasis.
What is the purpose of antihypertensive medicine?
Antihypertensives treat high blood pressure, or hypertension, with the goal of keeping your heart strong and preventing heart failure, a heart attack , kidney failure or a stroke. High blood pressure makes your heart’s job more difficult and more demanding. Bringing your blood pressure down makes it easier for your heart to keep pumping blood to your cells 24 hours a day.
What are the benefits of antihypertensive drugs?
Antihypertensive drugs help many people lower their high blood pressure and keep their hearts from becoming overworked. They also help people avoid having heart failure, kidney failure, a heart attack or a stroke.
What is the first line of treatment for hypertension?
First-line (first choice) options include these antihypertensive drugs: Thiazide diuretics, calcium channel blockers and ― for people who have kidney disease and heart failure ― angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs). Beta-blockers may also be first-line choices if you have a history of heart disease.
What does your provider consider when deciding which antihypertensive medication to give you?
In addition to your age, race and gender, your provider will consider your other health problems and how bad your blood pressure is when deciding which antihypertensive medication to give you. Your treatment will be different from your neighbor’s or your brother’s prescriptions because each of you has a unique situation.
How many people have high blood pressure?
Antihypertensive drugs are very common, as an estimated one billion people in the world have high blood pressure. In the United States, about 50% of people age 20 and older have high blood pressure and might take antihypertensive medication.
What does a saline solution do to your kidneys?
What they do: They help your blood vessels get wider and make your kidneys move extra fluid and salt into your pee.
What do syringes do to your body?
What they do: They keep your body from raising its blood pressure in a reaction to stress.
What is the name of the drug that stops the brain from sending signals that speed up your heart rate?
Nisoldipine ( Sular) Verapamil ( Calan, Covera, Isoptin, Verelan) Central Agonists. They stop your brain from sending signals that speed up your heart rate and narrow your blood vessels. These drugs are also called central-acting agents, central adrenergic inhibitors, and central alpha agonists.
What is the purpose of angiotensin blockers?
ARBs. Angiotensin II receptor blockers stop that same hormone from working. Your body makes it, but ARBs prevent the hormone from constricting the muscles in your blood vessels , like putting chewing gum in a lock.
What is the difference between ACE inhibitors and angiotensin II inhibitors?
ACE Inhibitors. Angiotensin-converting enzyme inhibitors prevent your body from making a hormone that tells blood vessels to tighten. With less of this hormone in your body, your blood vessels stay more open. Angiotensin II receptor blockers stop that same hormone from working.
What is the name of the drug that blocks calcium from entering the blood vessels?
Aliskiren ( Tekturna) is a direct renin inhibitor. Calcium Channel Blockers. They're sometimes called CCBs for short, or calcium antagonists. They don't let calcium into certain muscle cells in your heart and blood vessels, so it's harder for electrical signals to pass. Some CCBs keep blood vessels from tightening.
How does a syringe affect your heart?
They'll slow down your heartbeat and keep your heart from squeezing hard. This makes blood go through your vessels with less force.
What is the first blood pressure medicine?
These are often called " water pills ." They're usually the first type of high blood pressure medicine that your doctor will try.
Why do kidneys take salt out of the body?
They help your kidneys take salt and water out of your body. Because you have less total fluid in your blood vessels, like a garden hose that's not turned on all the way, the pressure inside will be lower.
Introduction
A Historical Perspective on Methodology
Results from The Literature
- We surveyed the literature for studies in healthy humans and patients with hypertension in which measurements of arterial blood pressure and renal hemodynamics had been made in the control condition of no drug therapy and following a minimum of 1 week of sustained drug therapy. We included only those in which a statistically significant fall in MAP (or bothsystolic and diastolic p…
Discussion
- Mechanisms of Afferent Arteriolar Dilatation
We have observed remarkable similarities of action of several families of antihypertensive agents that fairly selectively dilate the afferent arteriole, thereby permitting the kidney to operate at a new, lower MAP, with indices of renal function downstream of the afferent arteriole left unchanged (F… - Mechanism for Reduction of Pressure throughout the Renal Vasculature
The non-selective β-blocking drugs (propranolol, nadolol, and oxprenolol) appear unique in achieving their hypotensive action in association with a fall in GFR. They are also distinctive in reducing RBF and, in some studies, elevating RVR. We argue above, in relation to Figure 4, that th…
Conclusions
- Drugs proven to have sustained antihypertensive effects have profound actions on the kidney. These actions are of two main kinds: dilatation of the afferent arteriole, and inhibition of solute uptake from the renal tubule. Both actions change the hydrostatic pressure profile along the renal blood vessels, the first by changing vascular tone and the...
Author Contributions
- HD, MF, and KD have substantially contributed to the conception of the work, research in the literature, and the writing of the manuscript.
Funding
- Dr. Dorrington is supported by the Dunhill Medical Trust (grant R178/1110). Dr. Frise is the recipient of a British Heart Foundation Clinical Research Training Fellowship (FS/14/48/30828).
Conflict of Interest Statement
- The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.