Treatment of High Systolic & High Diastolic Blood Pressure
It sure is a very good idea to make good plans and follow them through in order to achieve goals. Well this also applies in the case of hypertension. We need to set goals to ensure a normal blood pressure. In cases of prehypertension it is important to adopt healthy lifestyle changes. If high blood pressure is present already, it is best to adopt healthy lifestyle changes also to see if it is effective in successfully controlling the blood pressure but if not it is best to begin drugs as prescribed by a doctor most preferably a cardiologist.
It is also important to note that your doctor has to work with you to develop a treatment plan according to whether it is a primary or secondary hypertension.. Treatment plans may be subject to change until blood pressure control is achieved. As mentioned earlier the key to optimum control is a combination of lifestyle changes and use of medications. We shall discuss these medications soon.
I sure hope we have not forgotten the lifestyle changes we discussed in the previous chapters. I would highlight a few of them but you can also go back to chapter 6 to read in full details. The lifestyle changes include:
- Maintaining a healthy weight
- Coping with as well as trying to limit stress to the barest minimum
- Being physically active (as well as exercising)
- Eating healthy
- Limiting alcohol intake
- Quit smoking
Now to the medications:
High blood pressure Medication
Antihypertensive drugs work in different ways to stop/ reduce some of the body’s function that cause hypertension. We would be discussing about nine classes of anti-hypertensive drugs.
- Diuretics: These are also known as water pills because they help to remove excess sodium from the body and consequently reduce the amount of water in the blood thereby reducing the blood pressure.They may be used as a single drug treatment (known as monotherapy) or they may be used in combination with other antihypertensive medications to enhance the effect of the other medications. The most commonly used ones are hydrochlorothiazide, furosemide, torsemide and metolazone.
- Beta Blockers: These class of antihypertensives help to reduce the heart beat and helps the heart to pump less blood through the blood vessels subsequently lowering the blood pressure. They are considered good treatment for hypertension because they also may treat coexisting medical problems such as chronic anxiety, migraines, headaches etc. NB: They should not be used in asthmatic patients as it can lead to increased wheezing. Example of Beta blockers include atenolol, propanolol, nadolol, bisoprolol.
- Calcium channel blockers: These drugs prevent the movement of calcium into the muscle cell of the heart and arteries (Calcium causes muscle contraction). They lower blood pressure by allowing the blood vessels to relax. Examples of calcium channel blockers include amlodipine, Nifedipine, felodipine, verapamil.
- Alpha blockers: These help to decrease blood pressure by reducing the nerve impulses that tighten blood vessels thereby allowing blood to flow freely. Examples of Alpha blockers include terazosm, prazosin, doxazosin, tamsulosin. Alpha blockers are particularly useful for patients with prostrate enlargement as they help to reduce urinary problems.
- Angiotensin converting enzyme (“ACE”) inhibitors: Remember in chapter one we discussed a certain hormone Angiotensin II which narrows blood vessels thereby increasing blood pressure. Angiotensin converting enzyme is the enzyme that converts Angiotensin I to Angiotensin II ( If we go down memory lane in chapter 1). Well, the Angiotensin converting enzyme inhibitors lock the conversion of Angiotensin I to Angiotensin II by stopping the production of angiotensin and lowering blood pressure. Examples of ACE inhibitors include Captopril, lisinopril among others.
- Angiotensin II Receptor blockers: These block angiotensin II hormone from binding with receptors in the blood vessels therefore the blood vessels do not constrict or narrow which would help to reduce the blood pressure. Examples of angiotensin II receptor blockers include Losartan, valsarton, telmisartan among others.
- Central Acting Agents: These act in the brain by decreasing nerve signals that narrow blood vessels and thereby lower blood pressure. Examples of central acting agents include: clonidine, Methyldopa.
- Alpha –Beta blockers: These reduce nerve impulses just like, alpha blockers but like beta blockers they also show the heartbeat thereby reducing blood pressure. Examples include carvedilol, labetalol
- Vasodilators: They relax the muscles of the blood vessel walls thereby reducing blood pressure. Examples include Nitroglycerin, hydralazine, alprostadil amongst others.
Now here is the thing, sometimes combining two or more of these medications in lower doses can reduce blood pressure more effectively. A doctor’s prescription is needed.
Talking about drug compliance, yes I know its not an easy thing to swallow antihypertensive pills everyday but trust me you would be doing yourself so much good and of course improving your quality of life by taking these medications. They should be taken in the correct dosage and at the right time to ensure that they work effectively just as prescribed by the doctor. In order words avoid skipping medications.
As said earlier do no forget to make some lifestyle changes to ensure that these work effectively in combination with the drugs to reduce blood pressure. I wish you the very best on your journey to either preventing or controlling blood pressure.