Lesson 5 - Hypertension Medications

Beta Blockers
Beta blockers work by reducing the nerve impulses to the heart. This, in turn makes the heart beat less often, and with less force. Subsequently, the heart doesn't work as hard, and blood pressure drops. Beta blockers include propranolol, metoprolol, and atenolol, among others.

ACE (angiotensin converting enzyme) Inhibitors
ACE inhibitors work by preventing the body's production of angiotensin II, a hormone that normally causes blood vessels to narrow. Consequently, the vessels remain wider, which lowers blood pressure. Angiotensin II also normally stimulates the release of another hormone, called aldosterone, which is responsible for the body's retention of sodium. Hence, in addition to creating wider vessels, by blocking aldosterone release, ACE inhibitors mimic the effect of diuretics to a certain extent, by helping the body excrete excess sodium and water, creating less fluid volume in the body. Subsequently, the blood vessels aren't subject to as much pressure, and the heart doesn't have to work as hard. Examples of ACE inhibitors include enalapril, captopril, and lisinopril.

Angiotensin II Antagonists
Relatively new to the world of blood pressure treatment, angiotensin II antagonists are primarily used for patients who develop a cough as a side effect of taking ACE inhibitors. This medication shields blood vessels from the hormone angiotensin II and its effects. Examples include losartan and valsartan.

Calcium Channel Blockers (CCBs)
CCBs work by keeping calcium from entering the muscle cells of the heart and blood vessels. As a result, the heart and vessels relax, allowing the blood pressure to go down. Some calcium channel blockers are nifedipine, verapamil, and diltiazem.

Alpha Blockers
Alpha blockers target the nervous system to relax blood vessels, allowing blood to pass more easily. Examples of alpha blockers are doxazosin, prazosin, and terazosin.

Alpha-Beta Blockers
As you might guess, alpha-beta blockers are basically a combination of alpha blockers and beta blockers. They target the nervous system to relax the blood vessels, as well as work to slow the heartbeat. As a result, less blood is pumped through wider vessels, decreasing the overall blood pressure. Alpha-beta blockers include labetalol and carvediolol.

Vasodilators
This category of medication works by relaxing the muscle in the blood vessel wall. Hydralazine and minoxidil are both generic forms of vasodilators.

Combinations

In many cases, doctors may choose to prescribe more than one of these medications. Using combinations of two different drugs (from different categories) can often improve the medication's efficacy.

Side effects
Like most drug treatments, hypertension medications may bring with them many side effects, ranging in gravity from minor — such as fatigue, coughing, or skin rash — to severe — such as sexual dysfunction, depression, heart dysfunction or electrolyte abnormalities. Use your common sense — if you begin a drug treatment and develop problems that you did not have prior to taking the medication, talk to your doctor about it. There are so many medications out there that he or she may be able to try a different drug, or perhaps change your dosage. It's pretty likely that with a bit of trial and error, your doctor can help you find a treatment that both controls your hypertension and allows you to maintain a good quality of life.

So, which one?

Many doctors prefer to start out newly diagnosed hypertension patients with diuretics or beta blockers. In fact, for groups that are especially sensitive to sodium — such as African Americans and the elderly — it is recommended that diuretics alone should be the first medication of choice. However, for hypertensive people with kidney problems or diabetes, guidelines suggest the use of ACE inhibitors as a first line of treatment. The details are endless, and we don't have room to discuss (and you probably don't feel like reading) all of them — so what does it all come down to? Each hypertension case and patient is unique. Your doctor must carefully examine your situation in its entirety prior to beginning treatment.

Assignment #2
Don't pretend like you didn't see this coming. I mean, really — we ARE in Lesson 5! Feel like you've got a little more knowledge about all those medications under your belt? Let's put it to the test with a retry of the Hypertension Medications quiz. Bet you're getting really, really good at his multiple choice thing, huh?

Assignment #3
Look in your medicine cabinet and make careful note of the names and dosages for all of the medications you are currently taking, including over-the-counter products, such as pain relievers, antihistamines, and sleeping aids. Take this list to your doctor or pharmacist and ask them to look it over in order to make sure you don't have any conflicts with the various prescriptions. Chances are, if you've gone to the same doctor for some time, or always get your prescriptions filled at the same pharmacy, that you won't have a problem. However, as we all know, it's better to be safe than sorry!

Assignment #4
Has your doctor prescribed a blood pressure medication for you? Whether you are currently taking one, or have been advised you will be put on one shortly, it is incredibly important that you ask the right questions of your doctor. print out this helpful list of questions to take with you to your next appointment, or to use as reference if you are having a phone conversation with your doctor. It's important you know how to make your medication work best for you, and how to avoid any complications.

Coming Up: Lesson #6 — What's the Big Deal?

It's nitty, it's gritty, but it's true. Hypertension is an enormous risk factor in the development of such serious health complications as stroke, kidney disease and heart attack. Now that you know how to prevent, recognize, and if necessary, treat hypertension, the next lesson will explore what ignoring all of this information could mean to you and your well being.

Other Options
Smarty pants, are you? Feel like jumping ahead? To access other lessons, just go back to t

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