New generation antihypertensives. Fast acting high blood pressure tablets. What to give preference

Modern drugs To treat hypertension, they must not only and not so much lower high blood pressure. Their task is to prevent irreversible damage to target organs and maintain target numbers blood pressure, prevent hypertensive crises and complications of hypertension. When prescribing a particular medicine, the doctor takes into account possible risks, tries to reduce the list as much as possible side effects. Let's consider general principles choice, list of antihypertensive drugs latest generation.

On the principles of choosing antihypertensive drugs

In 90% of cases it is explained by psycho-emotional factors. The problem is aggravated by poor lifestyle and nutrition. Isolated cases of increased blood pressure develop into illness.

Based on the nature of the disease, medications are prescribed according to extreme cases. Antihypertensive drugs have an impressive list of side effects. Influence the numbers high pressure using tablets is recommended only when the patient has minimized risk factors:

• gave up alcohol and smoking;
• lost excess weight;
• reduced the amount of salt in the diet, diversified it fresh vegetables and fruits;
• took up sports.

If lifestyle has changed and hypertension does not subside, anti-hypertension pills are prescribed. Principles of drug selection:

1. You need to start with half the dose. We drank and checked the pressure after half an hour. If there is no effect, increase the dosage.
2. The recommended dose should not be exceeded. Blood pressure medication does not help - you need to find another drug. And start again at half the dosage.
3. If the drug does not suit you due to side effects, stop taking it and consult your doctor for another prescription.
4. It is more convenient to take one blood pressure medicine rather than 2-3 tablets. New means are combination drugs, which contain several active substances.
5. It is advisable to find a drug that needs to be taken once a day. Many modern medicines have a prolonged effect.
6. It is important to take medications for high blood pressure daily, continuously. Even when you feel normal and the numbers on the blood pressure monitor are not elevated. Unauthorized breaks are unacceptable.

Hypertension can be called a purely individual disease. The same remedies help some patients well, but are completely ineffective against high blood pressure in others.

Classes of medications for hypertension

1. . Diuretics aimed at excretion excess liquid from the body. They have a number of side effects: dry mouth, tachycardia/bradycardia, dizziness, nausea, leg cramps, lethargy, frequent change moods.
2. . They reduce the secretion of a hormone that causes blood vessels to constrict. From unwanted effects – rapid decline blood pressure, allergies, dry cough.
3. . They reduce the heart rate, as a result of which the pressure normalizes. Side effects– strong reduction in pulse, lethargy, skin rashes.
4. . They affect the tone of blood vessels, relaxing their walls. As a result, the pressure normalizes. From negative effects We will note increased heart rate, dizziness, and strong hot flashes.
5. . They are prescribed if ACE inhibitors don't help. Drugs of this class protect the vasculature from angiotensin-2. Negative reactions of the body - nausea, allergies, dizziness.

New generation drugs directly inhibit renin activity. This is a hormone produced by the kidneys in response to problems in the body ( oxygen starvation organ). Due to increased secretion, the pressure rises. Today new tools are available for practical use.

Researchers are always looking for the most effective drugs, which should not only alleviate symptoms, but also reduce the risk of heart attacks, strokes, renal failure and similar complications. The list of new generation products is constantly growing.

For hypertension resistant to multicomponent drug therapy, selective endothelin receptor antagonists may be effective. The new tablets, which include five main classes, are considered the most effective.

General principles of purpose and combination

The list of medications for hypertension is longer. Until now, drugs that have been tested for decades are prescribed for blood pressure (well-known composition - new name). There is a lot that is new in this list (modern combinations, special mechanisms of action).

As a rule, doctors are guided the following recommendations according to medication prescription:

Possible combinations of drugs of different classes:

Today sartans are the drugs of choice. Medicines appeared in pharmacological practice relatively recently, but effectively reduce blood pressure. Taken once a day and lasts 24-48 hours.

List of drugs for hypertension

Hypertension drugs central action :

• . It has not been used in standard therapy for a long time. But it still has its adherents among older people who do not want to change treatment or are accustomed to active substances tablets.
• Moxonidine. Effective when metabolic syndrome And mild degree hypertension. It works very softly. Analogues – Physiotens, Tenzotran, Moxonitex.
• Andipal. Easy remedy. More suitable for the treatment of vegetative-vascular dystonia. It is not used for the treatment of hypertension.

A doctor must prescribe treatment and select medications. However, some information about medicines for hypertension will help the patient ask intelligent questions at the appointment.

You can stabilize blood pressure and improve the quality of life of hypertensive patients through conservative therapy. Typically, the patient is prescribed antihypertensive tablets for hypertension.

The doctor can prescribe diuretics, ACE inhibitors, calcium antagonists, centrally acting antihypertensives, sartans, and selective beta-1 blockers to the patient.

Clinical picture

What doctors say about hypertension

Doctor medical sciences, Professor Emelyanov G.V.:

I have been treating hypertension for many years. According to statistics, in 89% of cases, hypertension results in a heart attack or stroke and death. Currently, approximately two thirds of patients die within the first 5 years of disease progression.

The next fact is that it is possible and necessary to reduce blood pressure, but this does not cure the disease itself. The only medicine that is officially recommended by the Ministry of Health for the treatment of hypertension and is also used by cardiologists in their work is NORMIO. The drug acts on the cause of the disease, making it possible to completely get rid of hypertension. Moreover, within federal program every resident of the Russian Federation can receive it FOR FREE.

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For resistant forms of hypertension, combination drugs can be taken. If a person has grade 1 hypertension, then it is possible to stabilize blood pressure through the use of dietary supplements.

The most effective drugs for hypertension

Hypertension, according to WHO, is the most common pathology of cardio-vascular system. Men and women suffer from the disease equally often. Moreover, hypertension is usually diagnosed in patients over 40 years of age.

Hypertension is dangerous pathology. At untimely treatment the disease leads to cerebrovascular disorders, myocardial infarction, stroke, hypertensive crisis, and renal failure.

Arterial hypertension is difficult to compensate if the disease is accompanied by bradycardia, coronary disease heart, atherosclerosis (pathology accompanied by the deposition of cholesterol and lipoprotein fractions in the vessels).

Let's consider the classification of antihypertensive drugs:

1. Diuretic medications. Due to the removal of excess fluid from the body, the walls of blood vessels expand, the vascular lumen increases, and, accordingly, the creation of favorable conditions to lower blood pressure. The disadvantage of diuretics is the fact that they have many contraindications, including renal failure and diabetes mellitus in the stage of decompensation.
2. Beta blockers. By blocking beta-1 adrenergic receptors, medications reduce heart rate, lengthen diastole, reduce oxygen consumption by the heart muscle, and have an antiarrhythmic effect.
3. ACE inhibitors. They contribute to the inhibition of angiotensin-converting enzyme, due to which inactive angiotensin I is converted into angiotensin II, which in turn causes vasoconstriction.
4. Sartans. These new generation hypertension drugs are very effective. Medicines are used in great demand even in the EU countries and the USA. The latest generation of antihypertensive drugs block angiotensin II receptors, providing a long-lasting and persistent hypotensive effect.
5. Calcium channel blockers. The tablets prevent the rapid entry of calcium into cells. Due to this, expansion occurs coronary vessels and improvement of blood flow in the heart muscle.

All tablets for high blood pressure are completely incompatible with alcohol. During the treatment period, drinking alcohol is strictly prohibited. Ethanol not only levels healing effect drugs, but also increases the likelihood of side effects from the central nervous system and cardiovascular organs.

Trade names of the drugs are shown in the table below.

Accept antihypertensive drugs necessary daily. The dosage is selected by the attending physician. In resistant forms of hypertension, lifelong use may be indicated.

Centrally acting antihypertensives

Centrally acting antihypertensive drugs are rarely used today. The fact is that these medications often cause side effects. In addition, some drugs are addictive.

Centrally acting antihypertensive tablets are usually used when necessary to relieve hypertensive crisis. This need is due to the fact that the medications begin to act literally 20-40 minutes after administration.

The most effective medications of this type are:

• Clonidine.
• Moxonidine.
• Moxonitex.

You can take the above vasodilator drugs on an ongoing basis. But it is still not recommended to do this. Why? The fact is that today there are many effective antihypertensive drugs that are much better tolerated. The same ACE inhibitors or sartans act more gently, are not addictive, and provide a longer therapeutic effect.

Centrally acting antihypertensives are contraindicated during pregnancy. cardiogenic shock, renal failure, cerebral atherosclerosis.

Combined antihypertensive drugs

There are cases that medications for hypertension do not allow the patient to achieve stable stabilization of blood pressure. This phenomenon is usually observed in resistant forms of headache.

In this case, it is more advisable for the patient to take several antihypertensive drugs at once. But this is not very convenient and is expensive. In this case, antihypertensive combination tablets, which contain 2 active substances, help solve the problem.

Let's look at the most effective medications in this group:

1. Mikardis Plus.
2. Prestance.
3. Tarka.
4. Bisangil
5. Atakand Plus.
6. Capozide.
7. Noliprel.
8. Equator.
9. Enzix.

Supplements for high blood pressure

Modern medications for hypertension have many contraindications and side effects. In view of this, some patients prefer to take dietary supplements for plant based(biologically active additives).

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Such means are somewhat more effective than classic liqueurs hawthorn or motherwort. In addition, dietary supplements are not addictive, do not impair potency, and in some cases can even be prescribed to pregnant and lactating women.

The safest and most effective dietary supplements are:

• (erroneously called Normalif). Release form: tincture.
• BP-minus. Available in tablet form.
• Normaten. Release form: tablets.
• Hypertostop. Available in the form of drops.
• Cardimap. Release form: tablets.

The instructions for the above drugs say that the drugs can be used as part of complex therapy, that is, together with synthetic antihypertensive tablets. In addition, indications for the use of dietary supplements are neuroses, stress, and increased fatigue.

Dietary supplements should be taken with caution by hypertensive patients who are prone to allergic reactions.

Hypertensive drugs

It has already been noted above which drugs can be used to regulate high blood pressure. An equally common problem is arterial hypotension, that is, a decrease in blood pressure<90 на 60 мм.рт.ст.

Hypotensive patients have a question: which drug to choose to increase blood pressure? If we consider the most inexpensive means, we can mention Caffeine. It is enough to take 1-2 tablets once a day.

Effective means for normalizing blood pressure also include:

1. Dopamine hydrochloride.
2. Epinephrine.
3. Epiject.
4. Ephedrine hydrochloride.
5. Adrenalin.

In conclusion, I would like to note that before using any hypo- or hypertensive drugs, you should first consult with your attending cardiologist.

Also, if you have diseases of the cardiovascular system, do not forget about diet, an active lifestyle, and complete cessation of bad habits (smoking, alcoholism). For auxiliary purposes, hypertensive and hypotensive patients can take multivitamin complexes - Aevit, Alphabet, Doppelhertz Active Omega-3, Magne B6, Complivit, etc.

Drawing conclusions

Heart attacks and strokes are the cause of almost 70% of all deaths in the world. Seven out of ten people die due to blockages in the arteries of the heart or brain.

What’s especially scary is the fact that a lot of people don’t even suspect that they have hypertension. And they miss the opportunity to fix something, simply dooming themselves to death.

Symptoms of hypertension:

• Headache
• Increased heart rate
• Black dots before the eyes (floaters)
• Apathy, irritability, drowsiness
• Blurred vision
• Sweating
• Chronic fatigue
• Facial swelling
• Numb and chilly fingers
• Pressure surges

Even one of these symptoms should give you pause. And if there are two of them, then have no doubt - you have hypertension.

How to treat hypertension when there are a large number of medications that cost a lot of money?

Most medications will do no good, and some may even be harmful! At the moment, the only medicine that is officially recommended by the Ministry of Health for the treatment of hypertension is NORMIO.

Before The Institute of Cardiology together with the Ministry of Health is conducting a program " without hypertension". Within which the drug NORMIO is available FOR FREE, to all residents of the city and region!

Antihypertensive drugs are used to reduce blood pressure (blood pressure) both in hypertension and in symptomatic hypertension. Currently, a significant number of antihypertensive drugs are used in clinical practice. Depending on the mechanism of action, antiadrenergic agents, vasodilators, calcium antagonists, angiotensin II antagonists, and diuretics are distinguished.

In this material we will consider the general principles of action of antihypertensive drugs, focusing only on specific representatives of a particular group. If you are interested in a wider list of medications, with a detailed description of each, we recommend our newer material - Antihypertensives: more specifically.

Antiadrenergic agents act on the sympathetic nervous system. According to the mechanism of action, they can be ganglio- and postganglionic blockers, α-, β-adrenergic blockers, and also acting predominantly on central sympathetic activity.
Drugs that act primarily on central sympathetic activity include clonidine and methyldopa. The hypotensive effect of these drugs is due to a direct effect on the α-receptors of the CNS (central nervous system), at the same time they inhibit sympathetic impulses from the vasomotor center in the CNS, which leads to a decrease in blood pressure (blood pressure), bradycardia (decreased heart rate), a decrease in peripheral vascular resistance, including kidney ones. The drugs reduce plasma renin levels, have a moderate sedative effect, but retain sodium and water. When these drugs are combined with diuretics, the hypotensive effect increases significantly. The combination with reserpine is undesirable, since it potentiates drowsiness and depression. These drugs are used with caution in the elderly, since collapsed states and depression are possible. Clonidine and methylzhofa are discontinued gradually to avoid hypertensive crises (withdrawal syndrome may occur).
Clonidine(clonidine, hemitone, catapressan). The hypotensive effect occurs within 1 hour and lasts up to 8-12 hours. The initial dose is usually 0.1-0.15 mg per day, with most of the drug taken at night. The dose of the drug is increased every 2-3 days to 0.3-0.45 mg in 2-3 doses. 0.5-1.0 ml of 0.01% clonidine solution in 10 ml of isotonic solution is administered intravenously over 3-5 minutes. The same doses are administered intramuscularly. Clonidine is non-toxic, but can cause dry mouth, drowsiness, and constipation. After parenteral administration, orthostatic hypotension may occur. Contraindications: severe atherosclerosis, depression, alcoholism, severe heart failure. It is not recommended to prescribe clonidine to pilots and drivers during work. Release form: tablets of 0.075 mg and 0.15 mg, ampoules of 1.0 ml of 0.01% solution.
Methyldopa(dopegit, aldomet) use 0.25-0.5 g 2-4 times (up to 3 g) per day. You can take the entire daily dose at one time. The maximum effect occurs after 4-6 hours and lasts 24-48 hours. Methyldopa is most often combined with diuretics. The drug is usually well tolerated by patients, but dry mouth, lethargy, depression, sexual dysfunction, fever, and myalgia may occur. With long-term treatment, jaundice may occur due to intrahepatic cholestasis (stagnation of bile in the liver). Contraindications: acute hepatitis, liver cirrhosis, pheochromocytoma, pregnancy. Release form: tablets of 0.25 g.

Ganglioblockers(benzohexonium, pentamine) simultaneously block both sympathetic and parasympathetic nerve nodes. Due to the blockade of the parasympathetic nodes, paresis of the gallbladder, dry mouth, and impotence may occur. Therefore, these drugs are prescribed only perenterally for hypertensive crises. After each injection, the patient should lie or recline with his head elevated for about 2 hours to avoid orthostatic hypotension.

Benzohexonium has a hypotensive effect by reducing arteriolar tone and reducing general peripheral resistance; it significantly reduces venous tone and venous pressure, as well as pressure in the pulmonary artery and right ventricle. The drug has a sedative effect, inhibits thyroid function, and increases insulin sensitivity in patients with diabetes. Used intramuscularly or subcutaneously at 12.5-25 mg (0.5-1 ml of 2.5% solution). 0.5-1.5 ml of a 2.5% solution is administered intravenously over 2-5 minutes under blood pressure monitoring. You can repeat the injections 3-4 times a day. Benzohexonium is combined with diuretics, apressin, reserpine.

Contraindications: acute myocardial infarction, cerebral thrombosis, pheochromocytoma. Release form: ampoules of 1 ml of 2.5% solution. Pentamin administered only in a hospital, intramuscularly at 0.25-0.5 5% solution, intravenously at 0.2-0.5 ml of 5% solution in 20 ml of isotonic solution or 5% glucose solution. Release form: ampoules of 1-2 ml of 5% solution.

Postganglionic blockers: reserpine, raunatin, octadin.
Reserpine(rausedil, serpasil) destroys the sites of connection with adrenaline and other amines, resulting in a sympathetic blockade. The hypotensive effect is gradual - over several weeks. The parasympathetic effect is manifested in bradycardia, swelling of the mucous membrane of the nasopharynx, increased acidity of gastric juice, increased motility of the gastrointestinal tract, and miosis. Reserpine is used orally (preferably once before bedtime) at 0.1-0.25 mg, then the dose is gradually increased to 0.3-0.5 mg per day. The drug can be administered intramuscularly or intravenously, 1 ml of 0.1-0.25% solution. 10-14 days after achieving the hypotensive effect, the dose of the drug is slowly reduced. Abrupt withdrawal may cause cardiac arrest. Reserpine is best prescribed with diuretics, as it causes sodium and water retention; it potentiates (strengthens) the depressant effect (lowering blood pressure) of barbiturates and alcohol on the central nervous system (CNS). For many people, reserpine causes heart pain.

Contraindications: severe circulatory failure, bradycardia, gastric ulcer, nephrosclerosis, epilepsy, depression. Release form: tablets of 0.1-0.25 mg, ampoules of 1 ml of 0.1-0.25% solution.

Raunatin contains reserpine and other alkaloids, its hypotensive effect is more gradual than that of reserpine. Raunatin has antiarrhythmic properties; drowsiness and nasal congestion are observed less frequently. It is better to start treatment with 0.002 g at night, if necessary increasing the dose to 0.004-0.006 g per day. The hypotensive effect of raunatin is enhanced in combination with diuretics and vasodilators. Contraindications the same as for reserpine. Release form: tablets of 0.002 g.
Octadine(isobarine, guanethidine sulfate, ismelin). The hypotensive effect occurs after 4-7 days of treatment. Treatment begins with 12.5 mg 1 time per day in the morning after meals, after 5-7 days the dose is gradually increased by 12.5 mg. Due to the accumulation of the drug, the hypotensive effect may persist for 1-2 weeks after its discontinuation. When using Octadine, there may be pain in the parotid glands, bradycardia, swelling of the veins in the legs, and diarrhea. Contraindications: severe cerebral atherosclerosis, acute myocardial infarction, exacerbation of duodenal ulcer, renal failure, pheochromocytoma, pregnancy. Release form: tablets of 0.25 mg.
Combined drugs: cristepine (brinerdine) - 0.1 mg of reserpine, 0.58 mg of dihydroergotoxin and 5 mg of clopamide (brinaldix) in tablets; adelfan - 0.1 mg of reserpine and 10 mg of hydrolasine in 1 tablet; trirezide-K contains, in addition to these two drugs, 10 mg of hypothiazide and 0.35 g of potassium chloride.

α-blockers- phentolamine, tropafen and pyrroxane act for a short time and therefore they are used only for hypertensive crises. During injections and for 1.5-2 hours after it, the patient should be in a horizontal position to avoid orthostatic hypotension. When using these drugs, side effects are possible: dizziness, tachycardia, itching, swelling of the nasal mucosa, vomiting, diarrhea. Contraindications: coronary heart disease (CHD) with attacks of angina, severe heart failure, cerebrovascular accident. Release form: phentolamine(regitin) - ampoules of 1 ml of 0.5% solution, tropafene- ampoules of 1 ml of 1% or 2% solution, pyrroxane- ampoules of 1 ml of 1% solution. Hypotensive effect prazosin(adversuten) is accompanied by tachycardia, but when taking the first dose, hypotension may develop, including fainting. It also has a vasodilating effect. Begins treatment with a test dose of 0.5 - 1 mg at bedtime, then 1 mg 2-3 times a day. Gradually increase the dose to 20 mg per day in 2-3 doses. The full effect is assessed after 4-6 weeks. There are no contraindications. Release form: tablets of 1.2 and 5 mg, capsules of 1 mg.

β-blockers reduce the work of the heart and have a moderate disaggregant, vasodilator and sedative effect. They are especially indicated when there is an increase mainly in systolic blood pressure.
Anaprilin(Inderal, Obzidan, Propranolol) in people under 40 years of age promotes a clear decrease in blood pressure, in patients over 60 years of age the effect is less pronounced. The drug is prescribed orally before meals, gradually increasing the dose from 40 mg to 160-480 mg per day in 2-4 doses. A pronounced hypotensive effect is observed after 2-4 weeks of use. It is especially advisable to prescribe this drug to patients with angina pectoris and tachycardia.

Contraindications: bronchial asthma, severe circulatory failure, bradycardia, atrioventricular and sinoauricular blockade, weak sinus node syndrome, Raynaud's syndrome, pregnancy. Release form: tablets of 10 and 40 mg, ampoules of 1 and 5 ml of 0.1% solution.

Vasodilators divided into arteriolar and venous. Arteriolar vasodilators (apressin, diazoxide, minoxidil) reduce total peripheral resistance by direct action on arterioles. Due to the dilation of arterioles, cardiac output, heart rate and the force of myocardial contraction increase. But these drugs increase the myocardial oxygen demand, which can result in coronary insufficiency, and cause sodium and water retention, so they should be combined with diuretics.

Apressin(hydralazine, depressan) is one of the most powerful vasodilators, but its hypotensive effect appears gradually. Treatment begins with 10-25 mg 2-4 times a day, gradually increasing the dose to 100-200 mg per day. Contraindications: severe cerebral atherosclerosis, severe ischemic heart disease (coronary heart disease), systemic lupus erythematosus, gastric ulcer, active autoimmune processes, peripheral neuropathy. Release form: tablets of 0.01 and 0.025 g.
Diazoxide(hyperstat) - the maximum hypotensive effect occurs 2-5 minutes after intravenous administration and lasts 2-24 hours. Blood pressure usually does not fall below normal, and orthostatic hypotension does not develop. For hypertensive crises, 75-300 mg of the drug is administered intravenously quickly, without mixing with other solutions. Diazoxide is a strong uterine relaxant. Many patients develop transient hyperglycemia when using it. Contraindications: diabetes mellitus, severe renal failure, dissecting aortic aneurysm. Release form: tablets of 50 mg, ampoules of 20 ml (300 mg).
Minoxidil The action is similar to apressin, but more effective. The hypotensive effect occurs in the first 2 hours and lasts up to 24 hours. Use starting with a dose of 1-2.5 mg per day, followed by a gradual increase to 40 mg. Contraindications: renal failure. Release form: tablets of 0.001 g.
Arteriolar and venous dilator sodium nitroprusside(niprid), when administered intravenously, gives a hypotensive effect due to dilation of peripheral vessels and a decrease in peripheral resistance, as well as a direct effect on the vascular wall of arterioles and venules. The initial dose for intravenous administration is 0.05 g. The maximum dose should not exceed 0.15 g. Indications for the use of sodium nitroprusside: hypertensive crisis, arterial hypertension refractory (resistant) to conventional therapy. Used in hospital. Contraindications: coarctation of the aorta, arteriovenous shunts. Release form: ampoules of 50 mg of the drug.
Calcium antagonist phenigidine(nifedipine, Corinfar): the hypotensive effect is observed 30-60 minutes after taking the drug, reaches a maximum after 1-2 hours and lasts up to 4-6 hours. Apply 10-20 mg 3-4 times a day. Adverse reactions: feeling of heat, redness of the face, neck, hands; drowsiness, headache, swelling of the legs.

Contraindications: pregnancy. Release form: tablets and dragees, 0.01 g each.
Verapamil(isoptin) has a less pronounced hypotensive effect compared to phenigidine. Treatment begins with 40-80 mg per day, if necessary, the dose is gradually increased to 720 mg. Contraindications: circulatory failure. Release form: tablets of 0.04 and 0.08 g, ampoules of 2 ml of 0.25% solution.
Angiotensin II antagonist captopril lowers the concentration of angiotensin II and aldosterone in the blood, providing a strong and long-lasting hypotensive effect, reduces the frequency of cardiac contractions, and increases diuresis. Treatment begins with 25-50 mg 2-3 times a day, then gradually increases the dose to 600-800 mg per day.

Contraindications: renal artery stenosis, severe renal failure. Release form: tablets of 25, 50 and 100 mg.

Achieving a clear antihypertensive effect through monotherapy diuretics is associated with a high risk of complications due to loss of electrolytes in the urine. In this regard, it is necessary to examine the potassium content at least once every 3 months. Sodium and calcium in the blood, record ECG. It is advisable to use diuretics in combination with other antihypertensive drugs, mainly when diastolic blood pressure increases (the “water-salt form” of hypertension).
The most widely used in clinical practice is hypothiazide. After taking the drug in a dose of 100 mg, a clear hypotensive effect occurs after 3-5 hours, and a dose of 25-30 mg leads to a decrease in blood pressure after a day. The most pronounced effect is observed on the 5-7th day of treatment. Release form: tablets of 0.025 and 0.1 g.
Furosemide- the most powerful diuretic of the loop of Henle. The effect on blood pressure is somewhat inferior to hypothiazide. The hypotensive effect is observed 1-2 hours after taking the drug and lasts 5-8 hours. Release form: tablets of 40 mg, ampoules of 2 ml of 1% solution.
Ethacrynic acid(uregitis) does not provide a sufficient hypotensive effect and can only be used in combination with other drugs. Release form: tablets of 0.05 and 0.1 g, ampoules of 0.05 g of sodium salt of ethacrynic acid.
Klopamide(Brinaldix) has significant antihypertensive activity. Release form: tablets of 0.02 g.
The main advantage of potassium-sparing diuretics (spironolactone, triamterene) over other diuretics is that they remove little potassium salts from the body, so for prevention purposes they are usually used in combination with more powerful diuretics. Blood pressure decreases noticeably only after 2-4 weeks from the start of therapy spironolactone(veroshpiron, aldactone). Daily dose 50-400 mg in 2-4 doses. Release form: tablets of 0.025 g.
Triamterene the nature of its action resembles that of veroshpiron. Take 25 mg 2 capsules per day. Release form: capsules of 0.05 g.
Additional administration of hypothiazide can achieve a more significant reduction in blood pressure. A combination preparation is convenient for practical use triampur, containing 25 mg of triamterene and 12.5 mg of hypothiazide.
Intermittent use of diuretics is used as the main or as an additional method of treatment when prescribing other antihypertensive drugs. “Moderate diuretics” are prescribed, but with a long-lasting effect: hypothiazide, clopamide are taken for 2-4 days in a row, followed by a break of 2-3 days, a single dose 2 times a week is possible. For sodium-dependent ("water-salt" form of hypertension, continuous use of diuretics is recommended: small doses of hypothiazide (25-50 mg per day) in combination with triamterene 50-100 mg per day.

IN prevention And therapy In case of hypertension, a low-salt diet, regular physical activity, adequate sleep, and, if necessary, sedatives are of great importance. You should also not forget about natural remedies that lower blood pressure. Lately, the greatest interest has been, oddly enough,

Hypotensive effect - what is it? This question is asked by women and men who are faced with the problem of high blood pressure or hypertension for the first time and who have no idea what the hypotensive effect of the drugs prescribed to them by their attending physician means. An antihypertensive effect is a decrease in blood pressure under the influence of a particular drug.

Experienced professional therapists of the highest category at the Yusupov Hospital Therapy Clinic, who are proficient in advanced treatment and diagnostic methods, will provide qualified assistance to patients with arterial hypertension and select an effective treatment regimen that eliminates the development of negative consequences.

Antihypertensive therapy: general rules

Both symptomatic hypertension and hypertension require correction with drugs that have a hypotensive effect. Antihypertensive therapy can be carried out with drugs that differ in their mechanism of action: antiadrenergic agents, vasodilators, calcium antagonists, angiotensin antagonists, and diuretics.

You can obtain information about the hypotensive effect of the drug and what medications to take for high blood pressure not only from your doctor, but also from your pharmacist.

Arterial hypertension is a chronic disease that requires constant drug support, daily monitoring and regular use of prescribed medications. Not only the state of health, but also the life of a person depends on compliance with these rules.

Despite the general availability of treatment rules for reducing blood pressure, many patients have to be reminded what a treatment regimen for hypertension should look like:

• Antihypertensive medications should be taken regularly, regardless of the patient’s well-being and blood pressure level. This allows you to increase the effectiveness of blood pressure control, as well as prevent cardiovascular complications and target organ damage;
• It is necessary to strictly adhere to the dosage and use the form of the drug prescribed by the attending physician. Independently changing the recommended dose or replacing the drug may distort the hypotensive effect;
• even if you are constantly taking antihypertensive drugs, it is necessary to systematically measure blood pressure, which will allow you to evaluate the effectiveness of therapy, timely identify certain changes and adjust treatment;
• in the case of an increase in blood pressure against the background of constant antihypertensive treatment - the development of an uncomplicated hypertensive crisis, an additional dose of a previously taken long-acting drug is not recommended. Blood pressure can be quickly reduced using short-acting antihypertensive drugs.

Antihypertensive therapy: drugs to lower blood pressure

During antihypertensive therapy, several main groups of drugs that help lower blood pressure are currently used:

• beta blockers;
• ACE inhibitors;
• calcium antagonists;
• diuretics;
• angiotensin II receptor blockers.

All of the above groups have comparable effectiveness and their own characteristics that determine their use in a given situation.

Beta blockers

Drugs in this group reduce the likelihood of developing coronary complications in patients suffering from angina pectoris, prevent cardiovascular accidents in patients with myocardial infarction, tachyarrhythmia, and are used in patients with chronic heart failure. Beta-blockers are not recommended for patients with diabetes mellitus, lipid metabolism disorders and metabolic syndrome.

ACE inhibitors

Angiotensin-converting enzyme inhibitors have pronounced hypotensive properties, they have organoprotective effects: their use reduces the risk of complications of atherosclerosis, reduces left ventricular hypertrophy, and slows the decline in renal function. ACE inhibitors are well tolerated and have no negative effects on lipid metabolism and glucose levels.

Calcium antagonists

In addition to antihypertensive properties, drugs in this group have antianginal and organoprotective effects, help reduce the risk of strokes, atherosclerotic lesions of the carotid arteries and left ventricular hypertrophy. Calcium antagonists may be used alone or in combination with other drugs that have antihypertensive properties.

Diuretics

Diuretic drugs are usually used in combination with other antihypertensive drugs in order to enhance the therapeutic effect.

Diuretics are also prescribed to persons suffering from pathologies such as refractory hypertension and chronic heart failure. To avoid the development of side effects, when taking these drugs continuously, minimal dosages are prescribed.

Angiotensin II receptor blockers

Drugs in this group, which have neuro- and cardioprotective effects, are used to improve control of blood glucose levels. They can increase the life expectancy of patients suffering from chronic heart failure. Antihypertensive therapy using angiotensin II receptor blockers can be prescribed to patients who have had a myocardial infarction, suffer from renal failure, gout, metabolic syndrome and diabetes mellitus.

Antihypertensive therapy for hypertensive crisis

Even despite constant antihypertensive therapy, a sudden increase in blood pressure to fairly high levels may periodically occur (there are no signs of target organ damage). The development of an uncomplicated hypertensive crisis can be caused by unusual physical activity, emotional stress, consumption of alcohol or salty, fatty foods. This condition is not life-threatening, but it threatens the development of negative consequences, and therefore requires timely treatment.

A too rapid decrease in blood pressure is undesirable. It is optimal if in the first two hours after taking the drug the pressure decreases by no more than 25% of the initial values. Normal blood pressure values ​​are usually restored within 24 hours.

Rapid-acting medications help restore blood pressure control, providing an almost immediate hypotensive effect. Each of the drugs for quickly lowering blood pressure has its own contraindications, so a doctor should select them.

30 minutes after taking an antihypertensive drug, it is necessary to measure blood pressure to assess the effectiveness of therapy. If necessary, in order to restore normal blood pressure levels, after half an hour or an hour you can take an additional tablet (orally or sublingually). If there is no improvement (pressure decrease by less than 25% or its previous excessively high levels), you should immediately seek the help of a doctor.

In order to prevent arterial hypertension from becoming chronic, accompanied by quite serious complications, it is necessary to pay attention to the first signs of arterial hypertension in time. You should not self-medicate and randomly select drugs that reduce blood pressure. Despite their hypotensive effect, they can have a lot of contraindications and be accompanied by side effects that aggravate the patient's condition. The selection of medications for antihypertensive therapy should be carried out by a qualified specialist familiar with the characteristics of the patient’s body and his medical history.

The Therapy Clinic of the Yusupov Hospital offers a comprehensive approach to eliminating problems associated with high blood pressure.

The clinic has the latest modern diagnostic and treatment equipment from world leaders - manufacturers of medical equipment, which allows us to identify the first manifestations of hypertension at the earliest diagnostic level and select the most effective methods for treating the disease. When drawing up a treatment regimen, the patient’s age, condition and other individual factors are taken into account.

Conservative therapy at the Yusupov Hospital involves the use of the latest generation drugs that have minimal side effects. Consultations are carried out by highly qualified therapists who have extensive experience in treating hypertension and its consequences, including stroke.

You can make an appointment with the clinic’s leading specialists by phone or on the Yusupov Hospital website using the feedback form.

Bibliography

• ICD-10 (International Classification of Diseases)
• Yusupov Hospital
• Alpert, J. Treatment of myocardial infarction / J. Alpert. - Moscow: Mechanical Engineering, 1994. - 255 p.
• Guide to outpatient cardiology. - M.: GEOTAR-Media, 2007. - 400 p.
• Topolyansky, A.V. Cardiology. Handbook of a practical doctor / A.V. Topolyansky. - M.: MEDpress-inform, 2009. - 379 p.

Prices for diagnostic tests before prescribing antihypertensive drugs

*The information on the site is for informational purposes only. All materials and prices posted on the site are not a public offer, defined by the provisions of Art. 437 Civil Code of the Russian Federation. For accurate information, please contact the clinic staff or visit our clinic. The list of paid services provided is indicated in the price list of the Yusupov Hospital.

*The information on the site is for informational purposes only. All materials and prices posted on the site are not a public offer, defined by the provisions of Art. 437 Civil Code of the Russian Federation. For accurate information, please contact the clinic staff or visit our clinic.

Antihypertensive drugs are designed to lower blood pressure and are used to treat hypertension.

An increase in blood pressure itself may indicate the presence of a large group of diseases, although primarily these are diseases of the kidneys and arteries of the kidneys. However, arterial hypertension is also characteristic of thyrotoxicosis and some other diseases. The reasons, knowledge of which will prompt an appropriate treatment plan, should only be determined by a doctor.
In many cases, it is impossible to determine the diseases that lead to increased blood pressure, in which case hypertension is diagnosed.

Predisposing factors for this disease are excessive consumption of salt as it contains sodium, atherosclerosis, smoking, alcoholism, obesity, and a sedentary lifestyle.

When treating hypertension, doctors first try to eliminate the risk factors a person has or reduce their effect on the body. In many cases, these actions are enough to significantly reduce pressure.

When prescribing medications, doctors are guided by blood pressure parameters – the upper one, which characterizes the strength of heart contractions, and the lower one, which maintains vascular tone. Taking these indicators into account, medications are prescribed that either “slow down” the heart a little, or

Antihypertensive drugs lower blood pressure. They are used for arterial hypertension, when blood pressure is high, they can reduce it to normal levels. In this regard, such drugs are called antihypertensive drugs.

These drugs have their own classification based on their principle of action.

There are four groups in total.

The first includes medications that reduce the tone of the sympathetic nervous system. These are neurotropic antihypertensive drugs of central and peripheral action.

The first includes Clonidine (Clonidine, Gemiton), which increases the inhibitory effect of the vagus on the heart and reduces the stimulating effect of sympathetic innervation on the blood vessels and heart. Cardiac output and vascular tone decrease, and blood pressure also drops.

Clonidine is used primarily for the rapid reduction of blood pressure during hypertensive crises. In this case, the drug is administered intravenously over about six minutes.

In addition, similar centrally acting drugs include Moxonidine, which reduces the activity of the vasomotor center, cardiac output and blood vessel tone, Guanfacine, and Methyldopa, which is prescribed orally.

Drugs that block peripheral sympathetic innervation include ganglion blockers (azamethonium (pentamine), hexamethonium benzosulfonate (benzohexonium), gimpatolytics (reserpine, guanethidine), adrenoblockers (prazosin, terazosin, doxazosin).

In addition, a number of drugs are produced that inhibit the renin-angiotensin system. These are drugs that inhibit renin secretion, disrupt the formation of angiotensin II (ACE and vasopeptidase inhibitors) and interfere with the action of angiotensin II.

These are captopril, enalapril, perindopril, ramipril, fosinopril.

Myotropic vasodilators are also produced, which act directly on the smooth muscle fibers of blood vessels, initiating their relaxation, while the vessels dilate, and the dilation of arterial vessels leads to a drop in blood pressure. Similar substances include Diazoxide, Apressin, Magnesium sulfate, Sodium nitroprusside, Dibazol.

The fourth group includes diuretic () drugs.
These include Bekvorin, Birch buds and leaves, Brinaldix, Brusniver, Brusniver-T, Lingonberry leaves, Burinex, Bufenox, Vero-Indapamide, Herbafol, Hygroton, Hydrochlorothiazide-Verte, Hydrochlorothiazide, Hydrochlorothiazide-SAR, Hypothiazide, Polygonum renal herb, Polygonum bird grass, Diacarb, Disalunil, Diusemid, Difurex.

As you can see, there are many herbal preparations in this group.