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The Importance Of Blood Pressure Screening
Early detection of high blood pressure is critical to avoiding serious long-term health complications. There are not typically any warning signs or symptoms of high blood pressure, so its important to get your blood pressure regularly tested.
If your blood pressure is below 120/80 mm Hg, get screened at least once per year. If your blood pressure is consistently above 130/80 mm Hg, consult with your doctor about recommended screening frequency.
Remember that its never too early or too late to take up heart-healthy lifestyle habits. Staying active, avoiding cigarette smoke, limiting your sodium intake, and proactively managing stress can protect your health for years to come.
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Finding The Right Blood Pressure Medications For You
How blood pressure medicines work
Your body is constantly working to keep your blood pressure under control. There are receptors in your blood vessel walls which detect when your blood pressure is too high or low. In response, your nerves, hormones and kidneys all play a role in bringing it back to a safe level.
Over time, your blood pressure can creep up for a number of reasons, including an unhealthy lifestyle, and medications can help to bring it back down. They do this by acting on the ways your body controls blood pressure. Some affect the nerves or hormones which send signals to your blood vessel walls, telling them to relax or contract, while some affect the kidneys, causing them to remove excess salt and water from the blood.
Taking more than one medicine
Taking a combination of different medicines can work better than taking one, because they work in different ways. Taking a low dose of two medications rather than a high dose of one, can also help to avoid side effects, as side effects can sometimes be caused by the dose.
Sometimes a medication will work well to begin with, but with time your blood pressure might creep up again. You may then need to take another medicine alongside it which works in a different way.
Choosing a medicine to suit you
Which medications will be suitable for you depends on a number of things, including your:
Finding the right combination of medicines
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Common Types Of Blood Pressure Medications
High blood pressure, which affects nearly half of all U.S. adults, occurs when the force of the blood flowing through your arteries is consistently too high, forcing the heart to work harder. Over time, high blood pressure can damage major organs including the heart, brain, kidneys, and eyes and lead to life-threatening issues like heart disease, heart attack, and stroke.
With effective treatment, including both heart-healthy lifestyle habits and prescription blood pressure medications, you can control your blood pressure and live an active life. There are a variety of blood pressure medications, and it may take some time for you and your doctor to determine the best treatment for your needs. The good news is that with so many available and effective medications, youre likely to find one thats right for you. Read on to learn more about the most common classes of blood pressure medications and their side effects.
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High Blood Pressure Drugs
Some people find that lifestyle changes alone are enough to control their high blood pressure. But many also take medication to treat their condition. There are many different types of blood pressure medications with different modes of action.
If one drug doesnt lower your blood pressure enough, another might do the job. For some people, a combination of two or more drugs may be needed to keep their blood pressure under control.
Hypertension medications can be divided into the categories listed below, based on how they work. The drugs in each section are just a sampling of whats available.
Drug Types And Choices In Treatment
There are five major categories of medications that have been proven effective in treating hypertension:
Combination therapy would involve taking two anti-hypertensive medications, each from a different drug category.
Generally speaking, drugs from each of these classes tend to work equally well in controlling hypertension. That said, individuals may respond quite differently. Healthcare providers have no way of predicting this ahead of time, so they and patients must settle for an educated trial-and-error approach.
In guessing on the best initial single drug to try, most experts now recommend beginning either with calcium channel blockers and ARB/ACE inhibitors. While there are no hard and fast rules about which drugs to use in which people, there are certain tendencies that are useful in selecting single-drug therapy.
For instance, African American patients tend to do better with thiazide diuretics or calcium channel blockers. In addition, patients with certain medical conditions may benefit from one drug versus another.
For example, individuals with hypertension who also have diabetes or chronic kidney disease with albuminuria are generally prescribed an ACE inhibitor or an ARB .
Likewise, having a particular medical condition may sway a healthcare provider away from prescribing a certain anti-hypertensive medication. For example, ACE inhibitors are contraindicated in people with a history of angioedema or in women who are pregnant.
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Treatment For Specific Situations
Additional treatment options may be needed in certain situations like resistant hypertension or secondary hypertension.
Resistant hypertension refers to blood pressure that remains high after trying at least three different types of blood pressure medication. Someone whose high blood pressure is controlled by taking four different kinds of medication is considered to have resistant hypertension.
Even such hard-to-treat cases can often be managed successfully in time. Your doctor might prescribe a different medication, dose, drug combination, or more aggressive lifestyle changes.
Getting a referral to a heart or kidney specialist may also be useful in treating resistant hypertension.
Secondary hypertension is high blood pressure thats directly caused by another health condition or drug side effect. Blood pressure often drops substantially or even goes back to normal once doctors diagnose and treat the root cause.
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Beta Blockers And Diuretics
Beta blockers cause retention of sodium and water. Diuretics can cause mild volume reduction that leads to an increase in renin secretion by the kidney. The rationale for combining beta blockers with diuretics is twofold: beta blockers blunt the increase in the plasma renin level that is induced by diuretics, and diuretics decrease the sodium and water retention that is caused by beta blockers.6,20
The combination of a beta blocker and a diuretic produces additive effects compared with monotherapy using either agent alone. A recent study21 assessed the safety and efficacy of antihypertensive therapy using the cardioselective beta blocker bisoprolol alone and in combination with low dosages of hydrochlorothiazide. The dosages of bisoprolol were 2.5, 5 and 10 mg per day. The hydrochlorothiazide dosages were 6.25 and 25 mg per day. The study showed that monotherapy with either agent was more effective than placebo, but that when combination therapy was used, the beneficial effects were greater than when either agent was used alone .21
Dosage After A Heart Attack
When this drug is used after a heart attack, the dosage is highly individualized. It depends on the cause and the effects of the heart attack. Your doctor will monitor your blood pressure and how your heart is responding, and may adjust your dosage. This drug is often started in the hospital.
Atenolol is often dosed at 100 mg per day, given once a day or in two divided doses. The dosage is gradually adjusted if needed.
This medication has not been studied in children. It should not be used in children under the age of 18 years.
There are no specific recommendations for senior dosing. Older adults may process drugs more slowly. A typical adult dosage may cause levels of the drug to be higher than normal in your body. If youre a senior, you may need a lower dosage or you may need a different dosing schedule.
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Angiotensin Converting Enzyme Inhibitors
Angiotensin converting enzyme inhibitors are blood pressure medications that inhibit the activity of the enzyme angiotensin converting enzyme , which is important for controlling blood pressure.
Angiotensin II is a very potent chemical formed in the blood by ACE from, angiotensin I. When formed, angiotensin II causes the muscles surrounding blood vessels to contract, thus narrowing the vessels and increasing blood pressure.
ACE inhibitors are medications that inhibit the activity of ACE which decreases the production of angiotensin II. As a result, these medications cause the blood vessels to enlarge or dilate, and this reduces blood pressure. This lower blood pressure makes it easier for the heart to pump blood and can improve the function of a failing heart. In addition, the progression of kidney disease due to high blood pressure or diabetes is slowed.
Common side effects of this ACE inhibitors