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Hypertension is the medical term for high blood pressure. Untreated hypertension increases the strain on the heart and arteries, eventually causing organ damage. Hypertension increases the risk of heart failure, heart attack (myocardial infarction) and stroke. Fortunately, treatments for hypertension are effective and usually easy to take.
Making lifestyle changes is an important first step in the treatment of high blood pressure. In some patients, lowering sodium and alcohol intake, keeping weight in the ideal range, engaging in regular aerobic exercise, and no smoking may be sufficient to control hypertension. However, many patients also require one or more medications to lower the blood pressure.
Proper medication for you.
A healthcare provider will take several factors into account when determining which anti-hypertensive medication should be tried first. In addition to considering the effectiveness and potential side-effects, he or she will consider the person's general health, sex and age; the severity of the hypertension; any additional or underlying medical conditions; and whether particular medicines should not be used. The following is an overview of the different types of medicines that may be prescribed initially:
There are various classes of anti-hypertensive agents that are commonly used to reduce high blood pressure. Although generally well tolerated, anti-hypertensive medicines can cause side-effects; the side-effects depend upon the specific medicine given, the dosage, as well as other factors. Some people will respond well to one medicine but not to another; therefore, it may take time to determine the right medicine(s) and proper dosage to effectively lower blood pressure with a minimum of side-effects.
Diuretics lower blood pressure mainly by causing the kidneys to excrete more water and sodium, thereby reducing fluid volume throughout the body and widening (dilating) blood vessels.
Angiotensin converting enzyme (ACE) inhibitors block production of the hormone angiotensin II, a compound in the blood that causes narrowing of blood vessels and increases blood pressure. By reducing production of angiotensin II, ACE inhibitors allow blood vessels to widen, resulting in lower blood pressure and improved heart output.
Angiotensin II receptor blockers
The angiotensin II receptor blockers (ARBs) block the effects of angiotensin II on cells in the heart and blood vessels. Similar to ACE inhibitors, ARBs can widen blood vessels and lower blood pressure.
Calcium channel blockers
Calcium channel blockers reduce the amount of calcium that enters the smooth muscle in blood vessel walls and heart muscle. Muscle cells require calcium to contract. Thus, by inhibiting the flow of calcium across muscle cell membranes, calcium channel blockers cause muscle cells to relax and blood vessels to dilate, reducing blood pressure as well as reducing the force and rate of the heartbeat.
Beta blockers block some of the effects of the sympathetic nervous system, which increases the heart rate and raises blood pressure with stress and/or activity. Beta blockers lower blood pressure in part by decreasing the rate and force at which the heart pumps blood. Some beta blockers have combined activity, blocking both the beta and alpha receptors.
Alpha blockers relax or reduce the tone of involuntary (i.e. smooth) muscles in the walls of blood vessels (vascular smooth muscle), allowing the vessels to widen, thereby lowering blood pressure. An increase in blood vessel diameter is known as "vasodilation”.