High Blood Pressure Medications

The goal of these medications is to reduce cardiovascular strain and mortality. This is achieved by normalizing blood pressure

High blood pressure medications serve to reduce blood pressure. These medications are part of an exclusive class of drugs for hypertension.

Overall, the goal of these medications is to reduce cardiovascular strain and mortality. They do this by normalizing the blood pressure and controlling other cardiovascular risk factors.

Typically, patients combine this medication with changes to lead a healthier lifestyle and avoid bad habits.

Today, we’ll take a look at the characteristics of these drugs and how they are used.

First of all, do you know your blood pressure levels?

The following figures indicate the normal range for blood pressure:

  • At the doctor’s office: <140-90 mm Hg.
  • At home: <135-85 mm Hg.
  • With ambulatory monitoring: <125-80 mm Hg.

How blood pressure medications work

blood pressure medications
Angiotensin II is a peptide that comes from the activation of the Renin Angiotensin System. Sartanes increase levels of bradykinin in the plasma, which is a vasodilator that has the effect of reducing blood pressure.

It also stimulates the synthesis of aldosterone, which in turn increases your body’s re-absorption of sodium and water.

Antiotensin II works thanks to two types of receptors:

  • AT1 receptors are located in the smooth vascular muscle, the brain, the kidneys, and the lungs.
  • AT2 receptors are found in the reproductive organs, in fetal tissue, and in the brain.

In other words, the sartanes avoid binding to their primary receiver: AT1 receptors. These drugs can effectively control high blood pressure and prevent heart failure, hypertrophy of the left ventricle, and heart attacks.

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How these medications work

Angiotensin II receptors are high blood pressure medications that are more popular in recent years. One example of this class of drug is losartan. Its derivatives include candesartan, eprosartan, irbesartan, and more.

These drugs are responsible for blocking the enzyme known as angiotensin II, the AT receptor. Once the AT receptors are blocked, vasodilation occurs, vasopressin secretion is reduced, and there is less production of aldosterone. This, in turn, decreases your blood pressure.

Dr. Enrique Parafioriti has explained that competitive antagonists of angiotensin II receptors (AT1 and AT2 subtypes) like this peptide can be synthesized outside or RAS. Meanwhile, 38 AT1 blockers have more effective control than ACE inhibitors. In the heart, for example, the most important synthesis route is not through RAS, but by serine protease.

However, the effectiveness of each medication depends on three pharmacodynamics and pharmacokinetic characteristics: inhibition, affinity, and efficacy.

Inhibition

This allows for the analysis of blocking or inhibition of the effect that angiotensin II has on blood pressure. Among them are the following:

  • Valsartan 80mg: 30%
  • Telmisartan 80mg: 40%
  • Losartan 100mg: 25-40%
  • Irbesartan 150mg: 40%
  • Irbesartan 300mg: 60%
  • Olmesartan 20mg: 61%
  • Olmesartan 40mg: 74%

Affinity

Affinity
This involves the affinity of certain inhibitors:

  •  Losartan: 1000 times
  • Telmisartan: 3000 times.
  • Irbesartan: 8500 times.
  • Olmesartan: 12500 times.
  • Valsartan: 20000 times.

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Effectiveness

Some of the indicators of the time it takes for the medication to take effect are below:

  • Valsartan: 6 hours
  • Losartan: 6-9 hours
  • Irbesartan: 11-15 hours
  • Olmesartan: 13 hours
  • Telmisartan: 24 hours

Mechanisms

Mechanisms
High blood pressure medications cause a gradual decrease in blood pressure without altering your heart rate. It’s clear from the first dose that there will be a hypotensive effect, which is why it’s important to maintain the treatment for up to four weeks.

These are some of the following effects:

  • A regression of left ventricular hypertrophy.
  • A decrease in atrial and ventricular dilation in patients with acute myocardial infarction (AMI).
  • A decrease in kidney vascular resistance, which increases renal plasma flow and urinary sodium excretion.

Adverse effects

  • Insomnia
  • Dizziness
  • Drowsiness
  • Headaches
  • Low blood pressure
  • Increased potassium levels
  • Diarrhea or stomach distention
  • Respiratory infections: sinusitis, cold, nasal congestion

Interactions

  • Hyperkalmia can occur when these medications are combined with certain diuretics.
  • The intake of alcohol can reduce blood pressure, causing dizziness and drowsiness.
  • When combined with other high blood pressure medications, it can cause severe hypertension.
  • The consumption of amphetamines, asthma medications, or decongestants can decrease the therapeutic effect of these drugs.

Recommendations

Recommendations
Meanwhile, although a patient can be prescribed a certain medication, it’s important to combine them with healthy lifestyle habits.

The most commonly recommended measures include the following:

  • Avoid a sedentary lifestyle
  • Control your body weight
  • Avoid alcoholic beverages and tobacco products
  • Consume a diet that’s rich in potassium and calcium
  • Reduce your sodium intake
  • Avoid stress

Contraindications

Any drug belonging to this class of medications should not be taken during pregnancy, especially during the second and third trimesters. This is because it can cause the following: hypotension, kidney failure, or fetal death. On the other hand, during breastfeeding it can cause the heart to stop pumping blood properly, which causes problems with metabolism and the synthetic function of the liver.

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