The
Conventional Drugs of Choice for Hypertension
At this moment medicines for hypertension
is the core treatment for an immediate and sustained lowering of blood
pressure. In addition to the lifestyle changes which you should thoroughly
attend to, your doctor may prescribe anti-hypertension medicines. These
hypertension medicinal treatment are basically:
DIURETICS
Diuretics are also known as water pills. Diuretics are used to control water and electrolytes balance in our body. It increases urine outputs and sodium excretion.
The most often used diuretic to treat hypertension are the thiazides. They are also used to treat congestive heart failure and symptomatic edema. Thiazides are the recommended first-line treatment in the US guidelines and the National Institute for Health and Clinical Excellence/British Hypertension Society guidelines and a recommended treatment in the European (ESC/ESH) guidelines.
The short-term anti-hypertensive action is based on the fact that thiazides decrease preload, decreasing blood pressure. On the other hand the long-term effect is due to an unknown vasodilator effect that decreases blood pressure by decreasing resistance.
The antihypertensive actions of some diuretics (thiazides and loop diuretics in particular) are independent of their diuretic effect. That is, the reduction in blood pressure is not due to decreased blood volume resulting from increased urine production, but occurs through other mechanisms and at lower doses than that required to produce diuresis.
Lozol® (Indapamide) is used in the treatment of high blood pressure, either alone or in combination with other hypertension medications. Lozol is also used to relieve salt and fluid retention. During pregnancy, your doctor may prescribe Lozol to relieve fluid retention caused by a specific condition or when fluid retention causes extreme discomfort that is not relieved by rest. More about Lozol® or Indapamide
BETA - ADRENERGIC BLOCKERS
Beta-adrenergic blockers work to reduce the heart rate and lowering the tension during heart contractions.
Beta blockers (sometimes written as β-blocker) is a class of drugs used for various indications, but particularly for the management of cardiac arrhythmias, cardioprotection after myocardial infarction (heart attack), and hypertension.
Beta blockers may also be referred to as beta-adrenergic blocking agents, beta-adrenergic antagonists, or beta antagonists
CALCIUM CHANNEL BLOCKERS
Calcium channel blockers work as a blood vessel muscle relaxant as well as to reduce tension during heart contractions
A Calcium channel is an ion channel which displays selective permeabiltiy to calcium ions. It is sometimes synonymous as voltage-dependent calcium channel, although there are also ligand-gated calcium channels.
Calcium channel blockers (CCBs) are a class of drugs and natural substances that disrupt the calcium (Ca 2+) conduction of calcium channels.
It has effects on many excitable cells of the body, such as cardiac muscle, i.e. heart, smooth muscles of blood vessels, or neurons. Drugs used to target neurons are used as antiepileptics and are not covered in this article.
The main clinical usage of calcium channel blockers is to decrease blood pressure. It is for this action that they are used in individuals with hypertension.
ANGIOTENSIN CONVERTING ENZYME (ACE) INHIBITORS
Angiotensin Converting Enzyme (ACE) Inhibitors is meant to block the production of angiotensin II a potent substance that enhances contraction of the blood vessels.
Angiotensin-I converting enzyme (ACE, EC3.4.15.1), an exopeptidase, is a circulating enzyme that participates in the body's renin-angiotensin system (RAS), which mediates extracellular volume (i.e. that of the blood plasma, lymph and interstitial fluid), and arterial vasoconstriction. It is secreted by pulmonary and renalendothelial cells and catalyzes the conversion of decapeptide angiotensin I to octapeptide angiotensin II.
It has two primary functions:
In addition, inhibiting angiotension II formation diminishes angiotensin II-mediated aldosterone secretion from the adrenal cortex, leading to a decrease in water and sodium re-absorption and a reduction in extra-cellular volume.
ANGIOTENSIN RECEPTOR BLOCKERS (ARBs)
Angiotensin Receptor Blockers (ARBs) work on tissue receptors in our body by preventing the absorption of angiotensin II
Angiotensin II receptor antagonists, also known as angiotensin receptor blockers(ARBs), AT 1-receptor antagonists or sartans, are a group of pharmaceuticals which modulate the renin-angiotensin-aldosterone system. Their main use is in hypertension (high blood pressure), diabetic nephropathy (kidney damage due to diabetes) and congestive heart failure.
These substances are AT 1-receptor antagonists – that is, they block the activation ofangiotensin II AT 1 receptors. Blockade of AT 1 receptors directly causes vasodilation, reduces secretion of vasopressin, reduces production and secretion of aldosterone, amongst other actions – the combined effect of which is reduction of blood pressure.
The specific efficacy of each ARB within this class is made up of a combination of threepharmacodynamic and pharmacokinetic parameters. For these three key PD/ PK areas that indicate efficacy, it is important to see that one needs a combination of all three at an effective level; the parameters of the three characteristics will need to compiled into a table similar too one below, eliminating duplications and arriving at consensus values; the latter are at variance now.
ALPHA BLOCKERS
Alpha Blockers are meant to block stimulation from the nervous system that may trigger vasoconstriction or contraction of the blood vessels.
DIRECT VASODILATORS
Direct Vasodilators directly affect the blood vessels by opposing the vasoconstriction effect of angiotensin
Important Note: All the above medication or drug for hypertension should be within the knowledge and prescribed by your doctor. Strictly follow the instruction of use as directed by your doctor
Article by: Uno Birawan
At this moment medicines for hypertension
is the core treatment for an immediate and sustained lowering of blood
pressure. In addition to the lifestyle changes which you should thoroughly
attend to, your doctor may prescribe anti-hypertension medicines. These
hypertension medicinal treatment are basically:DIURETICS
Diuretics are also known as water pills. Diuretics are used to control water and electrolytes balance in our body. It increases urine outputs and sodium excretion.
The most often used diuretic to treat hypertension are the thiazides. They are also used to treat congestive heart failure and symptomatic edema. Thiazides are the recommended first-line treatment in the US guidelines and the National Institute for Health and Clinical Excellence/British Hypertension Society guidelines and a recommended treatment in the European (ESC/ESH) guidelines.
The short-term anti-hypertensive action is based on the fact that thiazides decrease preload, decreasing blood pressure. On the other hand the long-term effect is due to an unknown vasodilator effect that decreases blood pressure by decreasing resistance.
The antihypertensive actions of some diuretics (thiazides and loop diuretics in particular) are independent of their diuretic effect. That is, the reduction in blood pressure is not due to decreased blood volume resulting from increased urine production, but occurs through other mechanisms and at lower doses than that required to produce diuresis.
Indapamide was
specifically designed with this in mind, and has a larger therapeutic window
for hypertension (without pronounced diuresis) than most other diuretics.
Lozol® (Indapamide) is used in the treatment of high blood pressure, either alone or in combination with other hypertension medications. Lozol is also used to relieve salt and fluid retention. During pregnancy, your doctor may prescribe Lozol to relieve fluid retention caused by a specific condition or when fluid retention causes extreme discomfort that is not relieved by rest. More about Lozol® or Indapamide
BETA - ADRENERGIC BLOCKERS
Beta-adrenergic blockers work to reduce the heart rate and lowering the tension during heart contractions.
Beta blockers (sometimes written as β-blocker) is a class of drugs used for various indications, but particularly for the management of cardiac arrhythmias, cardioprotection after myocardial infarction (heart attack), and hypertension.
Propranolol was
the first clinically useful beta
adrenergic-receptor antagonist. Invented by Sir James
W. Black in the late 1950s, it revolutionized the medical
management of angina pectoris and is considered to be one
of the most important contributions to clinical medicine and pharmacology of
the 20th century.
Beta blockers may also be referred to as beta-adrenergic blocking agents, beta-adrenergic antagonists, or beta antagonists
CALCIUM CHANNEL BLOCKERS
Calcium channel blockers work as a blood vessel muscle relaxant as well as to reduce tension during heart contractions
A Calcium channel is an ion channel which displays selective permeabiltiy to calcium ions. It is sometimes synonymous as voltage-dependent calcium channel, although there are also ligand-gated calcium channels.
Calcium channel blockers (CCBs) are a class of drugs and natural substances that disrupt the calcium (Ca 2+) conduction of calcium channels.
It has effects on many excitable cells of the body, such as cardiac muscle, i.e. heart, smooth muscles of blood vessels, or neurons. Drugs used to target neurons are used as antiepileptics and are not covered in this article.
The main clinical usage of calcium channel blockers is to decrease blood pressure. It is for this action that they are used in individuals with hypertension.
ANGIOTENSIN CONVERTING ENZYME (ACE) INHIBITORS
Angiotensin Converting Enzyme (ACE) Inhibitors is meant to block the production of angiotensin II a potent substance that enhances contraction of the blood vessels.
Angiotensin-I converting enzyme (ACE, EC3.4.15.1), an exopeptidase, is a circulating enzyme that participates in the body's renin-angiotensin system (RAS), which mediates extracellular volume (i.e. that of the blood plasma, lymph and interstitial fluid), and arterial vasoconstriction. It is secreted by pulmonary and renalendothelial cells and catalyzes the conversion of decapeptide angiotensin I to octapeptide angiotensin II.
It has two primary functions:
- ACE
catalyses the conversion of angiotensin
I to angiotensin
II, a potent vasoconstrictor in a substrate
concentration dependent manner.
- ACE
degrades bradykinin, a potent vasodilator,
and other vasoactive peptides,
These two actions make ACE inhibition a
goal in the treatment of conditions such as hypertension, heart failure, diabetic nephropathy, and type 2 diabetes mellitus. Inhibition of ACE
(by ACE inhibitors) results in the decreased
formation of angiotensin II and decreased metabolism of bradykinin, leading to
systematic dilation of the arteries and veins and a decrease in arterial blood
pressure.
In addition, inhibiting angiotension II formation diminishes angiotensin II-mediated aldosterone secretion from the adrenal cortex, leading to a decrease in water and sodium re-absorption and a reduction in extra-cellular volume.
ANGIOTENSIN RECEPTOR BLOCKERS (ARBs)
Angiotensin Receptor Blockers (ARBs) work on tissue receptors in our body by preventing the absorption of angiotensin II
Angiotensin II receptor antagonists, also known as angiotensin receptor blockers(ARBs), AT 1-receptor antagonists or sartans, are a group of pharmaceuticals which modulate the renin-angiotensin-aldosterone system. Their main use is in hypertension (high blood pressure), diabetic nephropathy (kidney damage due to diabetes) and congestive heart failure.
These substances are AT 1-receptor antagonists – that is, they block the activation ofangiotensin II AT 1 receptors. Blockade of AT 1 receptors directly causes vasodilation, reduces secretion of vasopressin, reduces production and secretion of aldosterone, amongst other actions – the combined effect of which is reduction of blood pressure.
The specific efficacy of each ARB within this class is made up of a combination of threepharmacodynamic and pharmacokinetic parameters. For these three key PD/ PK areas that indicate efficacy, it is important to see that one needs a combination of all three at an effective level; the parameters of the three characteristics will need to compiled into a table similar too one below, eliminating duplications and arriving at consensus values; the latter are at variance now.
ALPHA BLOCKERS
Alpha Blockers are meant to block stimulation from the nervous system that may trigger vasoconstriction or contraction of the blood vessels.
α blockers or (adrenergic)
α-antagonists are pharmacological agents that act asantagonists of α adrenergic receptors (α-adrenoceptors).
α blockers are used in the treatment of
several conditions, such as Raynaud's disease, hypertension, and scleroderma.
DIRECT VASODILATORS
Direct Vasodilators directly affect the blood vessels by opposing the vasoconstriction effect of angiotensin
Important Note: All the above medication or drug for hypertension should be within the knowledge and prescribed by your doctor. Strictly follow the instruction of use as directed by your doctor
Article by: Uno Birawan
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