A review of the new generation of high-pressure tablets

In the entire civilized world, six different groups of drugs are used that reduce blood pressure.

Let's say right away that it's not so simple to understand their peculiarities for a person who is not versed in medicine, but Russian consumers who are ready to penetrate deeply in pharmacological details and carefully study the instructions to the drugs, if desired and a good supply can precisely cope with this task.

In this article, we consider the top of the most frequently prescribed tablets from high blood pressure. Reviews and prices for drugs are attached.

Norm

The norm of arterial pressure in adults is as follows:

• Reduced blood pressure is 100-110 / 70-60 mm Hg.
• The most optimal is the pressure 120/80 mm Hg.
• Slightly elevated is called AD 130-139 / 85-89 mmHg.
• High pressure is considered to be more than 140/90 mm Hg.

Since age causes a variety of changes in the human body, you should take them into account when measuring the pressure. Children and adolescents often have low blood pressure, while older age is characterized by a higher value.

What exacerbates the clinical picture with high blood pressure?

In people under 60 years old, those who suffer from diabetes or kidney diseases, it is desirable to keep the indicators of AD 120-130 at 85 mm Hg.

There is the following qualification of risk factors for hypertension:

1. Smoking;
2. Age indicators (the risk of developing a malaise increases for men after 55 years, and women for 10 years older);
3. Cholesterol indicators (if above 6.5 mol / l.);
4. When the patient is sick with diabetes mellitus;
5. Hereditary factor.

Factors that can increase the risk of death in people with hypertension:

• suffered stroke or cerebral ischemia;
• heart failure, coronary heart disease, myocardial infarction;
• renal failure, diabetic nephropathy;
• presence of signs of peripheral vascular lesions, exfoliating aortic aneurysm;
• changes in the retina of the eye - exudates, hemorrhages, edema of the nipple of the optic nerve.

However, the highest risk of death is observed in patients who have four manifestations at once:

• arterial hypertension;
• elevated cholesterol;
• obesity;
• high blood sugar.

Nevertheless, many people can not assess the risks of hypertension correctly and adequately, believing that elevated blood pressure is not terrible, and even knock it down without pills.

There are several categories of patients with hypertension. The former ignore the risk of AD risks and try to live up to the limits of their health endurance. Thus, considering that if the ailment does not cause significant discomfort, then you can dispense with blocking jumps of AD tablets. The second patient, on the contrary, overestimates the risk and tries to heal the ailment with all the drugs that come under his arm, not paying attention to the side effects, but ignoring the visits to the doctor.

Do not self-medicate

Today, drugs for the treatment of hypertension are issued by many pharmaceutical companies. They are divided into large groups depending on the action and chemical composition. Prescribe drugs for hypertension should the attending physician after the examination and accompanying examination.

The increased pressure can be treated in many ways and the choice of the agent depends largely on the individual characteristics of the patient. What medications are suitable in this case can be learned based on the experience of the doctor and the patient's reaction to the tablets.

What drugs are prescribed?

It is advisable to consider the main drugs:

1. Beta-blockers. This is a special medication for reducing blood pressure, by lowering the heart rate. But, the reverse side of them in the form of side effects - weakness, skin rashes, excessive slowing of the pulse.
2. Diuretics. This is a group of drugs with a diuretic effect. They are accepted in order to quickly reduce blood pressure by removing fluid from the body. But, taking these medications can adversely affect the work of the heart, lead to dizziness, the appearance of seizures and nausea.
3. ACE Inhibitors. The body can produce a large amount of a hormone, which negatively affects the vessels, narrowing them. This group of drugs is aimed at reducing the amount of hormone produced. As a result, blood pressure drops when the vessels expand. Negative effects of inhibitors can manifest as allergic reactions or a sudden onset of coughing.
4. Angiotensin antagonists. High blood pressure can be due to angiotensin 2, and the drugs in this group block this action. But as a result, dizziness may occur, accompanied by nausea.
5. Calcium antagonists. The main purpose of such drugs is to have a relaxing effect on the blood vessels, as a result of which blood pressure decreases. Side effects after taking such drugs are manifested in the form of hot flashes, rapid heartbeats, sometimes even dizziness.

The table presents a general list of drugs from different pharmacological groups assigned at elevated pressure:

Names of preparations	Pharmacological group
Verapamil, Amlodipine, Diltiazem	Calcium antagonists
Indapamide, Furosemide, Torasemide, hydrochlorothiazide, Triamterene, Veroshpiron.	Diuretics (diuretics)
Enalapril, Captopril, Cisinopril, Prestarium, Zocardis	ACE Inhibitors
Terazozin, Artesin, Doxazosin, Proxodolol, Urerek	Alpha-blockers
Atenolol, Metoprolol, Praxtolol, Propranolol, Pindolol, Bisaprolol	Selective and nonselective β-blockers
Lozartan, Valsartan, Eprosartan, Candesartan, Cardosal	Angiotensin receptor blockers, or Sartans

These medicines are indicated for the treatment of arterial hypertension (persistent increase in pressure) of any degree. The stage of the disease, age, the presence of concomitant diseases, the individual characteristics of the organism are taken into account when choosing a remedy, selecting a dosage, the frequency of administration, and the combination of drugs.

Tablets from the group of Sartans to date are considered the most promising and effective in the treatment of hypertension. Their therapeutic effect is due to the blocking of receptors to angiotensin II - a potent vasoconstrictor that causes a steady and rapid increase in A / D in the body. Tablets with long-term admission give a good therapeutic effect without the development of any undesirable consequences and withdrawal syndrome.

Below is a list of the most effective drugs from high blood pressure:

Non-proprietary international name	Trade name of different pharmaceutical manufacturers
Losartan	Lozap, Lorista
Diltiazem	Cardil, Diacordin
Metoprolol	Metocard, Egilok
Amlodipine	Norvasc, Amlodak, Amlokor
Verapamil	Finoptin, Isoptin, Flamon
Lisinopril	Diroton, Lysinoton
Valsartan	Nortivan, Teveten, Nortivan
Captopril	Kapoten
Enalapril	Enap, Berlipril

That is why it is necessary to consult a doctor and prescribe effective therapy for treating hypertension.

Extended-release tablets

The drugs have a long therapeutic effect, which is convenient in the treatment of hypertension. It is enough to take only 1-2 tablets per day to normalize the pressure at home and achieve a stable remission.

List of long-acting drugs of a new generation:

• Metoprolol - 29.00 rub.
• Diroton - 108.00 rub.
• Losartan - 109.00 rub.
• Cordaflex - 91.00 rub.
• Prestarium - 366.00 rub.
• Bisoprolol - 31.00 rub.
• Propranolol - 182.10 rub.

These drugs are used for long-term combination therapy for hypertension of 2-3 degrees. Features of the reception are a long-term cumulative effect. To obtain a stable result, you need to take these drugs for 3 or more weeks, so do not stop taking the medication if the pressure does not decrease instantly.

Tablets with a quick effect

List of antihypertensive agents of rapid action:

• Furosemide - 20.00 rub.
• Anaprilin - 22.00 rub.
• Captopril - 13.00 rub.
• Adelphan - 1189.56 rubles.
• Enalapril - 9.00 rub.

At high pressure it is enough to put half the tongue or a whole tablet of Captopril or Adelfan and dissolve. The pressure will drop in 10-30 minutes. But it is worthwhile to know that the effect of taking such funds is short-lived. For example, Captopril the patient is forced to take up to 3 times a day, which is not always convenient.

Rauwolfia preparations: why is their use impractical?

These drugs previously reasonably treated with arterial hypertension. The most popular products from this category are Raunatin, Reserpine. They are direct antispasmodics, which, in addition, provoke a delay in the body of sodium and water.

Taking such a drug, you need to consider that it helps with pressure very slowly - the effect is observed only after 1-2 weeks. after the beginning of treatment. A persistent drop in blood pressure is observed in only about a quarter of patients. Consequently, these drugs can not be considered a modern antihypertensive drug. However, there is another important factor why these tablets should not be used. The reasons - in a large number of side effects that occur when taking such drugs. Thus, there is evidence that the frequency of development of breast cancer increased with the use of rauvolfia drugs. It was also noted that when taking such drugs, potentiation of the development of pancreatic cancer was noted.

Therefore, in many countries, medicines containing reserpine have been banned. In addition to these adverse effects, these drugs also cause the following side effects: drowsiness, nasal congestion, bronchospasm, gastrointestinal ulcers, arrhythmia, depression, edema, impotence.

Management of hypertensive crisis

At crises already refused intramuscular injections of magnesia or other preparations.

To date, the hypertensive crisis is docked:

1. A 10 mg (less often 5 mg) tablet of nifedipine (corinphar) is dosed down under the tongue.
2. Or 25 - 50 mg of a kapotene (this is the best medicine for a crisis).

Also used is physiotens (moxonidine) at a dose of 0.4 mg or clonidine (clonidine) at a dose of 0.075-0.15 mg.

The latter drug is used only in those who chronically take clonidine, which is now removed from the treatment standards.

Are there safe drugs?

When high blood pressure interferes with normal functioning, the question arises of how to find the safest drugs without side effects. Unfortunately, science did not give such drugs. After all, it is extremely difficult to develop a universal drug that would suit every patient, but it did not have any side effects.

Still, the new generation drugs have significant advantages over obsolete means for the treatment of hypertension, they are as follows:

1. Drugs with prolonged action. Consequently, the dosage of the drug is reduced and thus the risk of side effects is minimized.
2. Minimizing side effects. Absolutely safe preparations for each patient does not exist, but new developments select components in such a way that they do not cause negative reactions of the body.
3. Technologies of modern times give more effective drugs for the treatment of hypertension.
4. Complex preparations have been developed. The risk of side effects is so low that the drug can be considered absolutely safe.

Hypertension in the elderly

• Drugs of the first choice at increased pressure in the elderly are diuretics: hypothiazide or indapamide (with diabetes mellitus). The low cost and high effectiveness of this group of drugs makes it possible to use them for one-component therapy in mild hypertension. They are also preferred for volume-dependent hypertension in women in menopause.
• The second row is the calcium channel blockers dihydropyridine series (amlodipine, nifedipine), which are indicated in atherosclerosis and diabetes mellitus against a background of weight problems.
• The third place - in lisinopril and sartans.

Combined preparations: prestan (Amlodipine + Perindopril), tar (Verapamil + Trandolapril).

Combination Therapy

Combination therapy of hypertension implies the simultaneous reception of drugs of various types, the most popular and effective of which are:

1. Diuretics and sartans. Combinations of the following drugs: gisaar (lozartan-gipotiazid), atakand plus (candesartan-hypothiazide), mycardis plus (telmisartan-hypothiazide), co-sproale (iprosartan-hypothiazide).
2. Diuretics and ACE inhibitors. Combinations of drugs of these groups - ramipril-gipotiazid (amprilan, hartil), lisinopril-gipotiazid (iruzid), enalapril-indapamide (enziks), enalapril-hypothiazide (enap NL, berlipril plus), captopril-hypothiazide (kaposide), perindopril-indapamide (noliprel).
3. Diuretics and beta blockers. The combination of bisoprolol with hypothiazide (bisangyl) is used to minimize the risk of complications from the cardiovascular system.
4. Ca-channel blockers along with angiotensin converting enzyme inhibitors. This combination can also be used for the therapy of resistant forms of hypertension, because using these drugs does not reduce the sensitivity of the body to medicines. Includes the following combinations: amlodipine with perindopril, trandolapril with verapamil.
5. Blockers of calcium channels with sartans. Combinations of the following drugs: telmisartan with amlodipine, losartan with amlodipine.
6. Diuretics with calcium channel blockers. The most popular combination is chlorthalidone and atenolol.

Treatment of resistant hypertension

Resistance arterial hypertension is a form of the disease in which it can not be treated with mono drugs, and even therapy with a combination of drugs from two different groups does not yield results.

To normalize the pressure indicators, the following combinations of pharmaceuticals with different properties are used:

1. Beta blockers, dihydropyridine calcium channel blockers, ACE inhibitors;
2. Blockers of beta-receptors, calcium channels and sartan;
3. Diuretics, angiotensin converting enzyme inhibitors, Ca-channel blockers.
4. The third scheme, combining the use of diuretics and Ca-channel blockers along with ACE inhibitors, is considered to be the best method for the treatment of resistant hypertension. For these purposes, a combination of spironolactone and thiazide diuretics is also used.

In view of the existence of a huge list of drugs and treatment regimens for arterial hypertension, medicines that are used for different forms of the disease and are appointed individually, self-medication can be not only ineffective, but also dangerous for health. Timely contact with a doctor allows you to minimize the risk of stroke, heart attack (causes and symptoms of myocardial infarction) and other complications of the disease.

When you can not do without a doctor?

In the treatment of hypertension, other drugs are traditionally used, which, in general, do not have pronounced features inherent in any particular group of hypotensive. For example, the same dibasol or, say, magnesium sulfate (magnesia), which is successfully used by emergency doctors to stop the hypertensive crisis. Introduced into a vein, sulfate-soluble magnesia has an antispasmodic, soothing, anticonvulsant and slightly hypnotic effect. A very good drug, however, it is not easy to administer: it needs to be done very slowly, so the work is stretched for 10 minutes (the patient becomes unbearably hot - the doctor stops and waits).

For the treatment of hypertension, in particular, with severe hypertensive crises, pentamine-N (cholinic blocker of sympathetic and parasympathetic ganglia, reducing the tone of arterial and venous vessels), benzohexonium, similar to pentamine, arfonade (ganglioblocker), aminazine (phenothiazine derivatives). These drugs are designed for emergency care or intensive care, so they can only be used by a doctor who knows their characteristics well!

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