Hypertension (high blood pressure) is a serious health issue, and treating it is not always an easy task. A medication that works well for one person, may not be the best option for another. There are many medications that can prescribed for hypertension, some more effective than others, depending on the patient. It is important to remember that only your doctor can tell you which medication is best for you, so careful consultation is advised for anyone needing more information or planning treatment.
Diuretics
These medications work by promoting the excretion of fluids and decreasing total blood volume. There are different types of these drugs, namely those belonging to the thiazide class, loop diuretics and aldosterone blockers.
Thiazides have been found to be the most effective for patients with uncomplicated hypertension, that is, high blood pressure that is present without other systemic diseases.
Loop diuretics are the diuretic of choice in those with chronic kidney disease or heart failure, because of their powerful effects. They are especially effective at excreting sodium and water from the kidneys.
Aldosterone blockers are the best anti-hypertensive when increased levels of the hormone aldosterone are to blame for the increased blood pressure.
Angiotensin-converting Enzyme Inhibitors (ACE-Inhibitors)/Angiotensin Receptor Blockers (ARB's)
These medications have considerable effects on the amount of fluid reabsorbed by the kidneys. They work well in conjunction with other therapies such as diuretics. They have a low side effect profile, are especially effective in patients with diabetes, and have protective effects on the kidneys in those with kidney disease. Angiotensin receptor blockers are as effective as ACE-inhibitors, but are typically used when ACE-inhibitors are not well tolerated.
Calcium Channel Blockers (CCB)
These medications work by dilating blood vessels and decreasing the rate and contraction ability of the heartbeat. They protect against heart attack and stroke. They are used to complement existing therapy, as more than one medication is typically needed to control blood pressure.
Beta Blockers
These medications serve to decrease the heart's oxygen requirement and work by blocking B1 and/or B2 receptors located in the heart, lung and blood vessels. They are first line therapy for any hypertensive patient who also has coronary artery disease or who has experienced a heart attack. Heart failure should be stabilized however, before starting beta blocker therapy. One of the newer beta blockers, atenolol, seems to cause fewer side effects, especially in younger patients and those with metabolic disease such as diabetes or hyperlipidemia.
References
- "Cecil Medicine, 23rd Edition;" Goldman 2007
- American Family Physician. "Thiazide Diuretics Remain First-Line Treatment for Hypertension." Moon K. Volume 80, Issue 8 (October 2009)
- American Heart Journal. "Coronary heart disease in moderately hypercholesterolemic, hypertensive black and non-black patients randomized to pravastatin versus usual care: The Antihypertensive and Lipid Lowering to Prevent Heart Attack Trial (ALLHAT-LLT)." Margolis K, Dunn K, Simpson L, et al. Volume 158, Issue 6 (December 2009)
