What are they
Antihypertensives are drugs used to reduce blood pressure which, if higher than normal, is an important cardiovascular risk factor.
To this category belong many classes of molecules (see table), diversified according to the mechanism of action. They can be used individually (monotherapy) or in combination (combination therapy).
Class of hypertensives | Active ingredients |
---|---|
Diuretics | Hydrochlorothiazide, chlorthalidone, furosemide, ethacrynic acid |
Beta-blockers | Atenolol, propanolol, carvedilol |
ACE inhibitors | Enalapril, captopril, lisinopril, perindopril, ramipril |
Calcium channel blockers | Verapamil, dilitiazem, amlodipine, nifedipine |
Sartans | Telmisartan, losartan, valsartan, irbesartan, candesartan |
Diuretics
They are able to increase the elimination of fluids through the urine. Increased diuresis leads to a reduction in blood volume and its pressure inside the vessels.
Drugs with diuretic action are numerous and belong to different classes: in most cases they act on the kidneys, the organs responsible for eliminating metabolic waste through the production of urine.
Among the most commonly used diuretics are hydrochlorothiazide, chlorthalidone, furosemide, ethacrynic acid.
Beta blockers
They are molecules that act directly on the heart, blocking the action of beta receptors of the sympathetic nervous system (beta-adrenergic receptors).
The inhibition of these structures puts the heart muscle “at rest”: the force of contraction and cardiac output are reduced, functions that help determine the thrust power of the heart.
In this way blood is pumped with less energy into the circulatory system and blood pressure is reduced. The most frequently used beta blockers include atenolol, propanolol, carvedilol.
ACE inhibitors
They inhibit the formation of a hormone that determines the contraction of the vessels and the balance of certain salts in the body.
With these drugs the lowering of pressure is mediated by a peripheral phenomenon, namely a lower vascular resistance to blood circulation.
ACE inhibitors block the action of an enzyme, angiotensin converting enzyme (ACE), which promotes the formation of angiotensin II from angiotensin I.
The blockade of this enzyme causes a dilation of the vascular walls and a reduction in blood pressure. Among the most used molecules are enalapril, captopril, lisinopril, perindopril and ramipril.
Calcium channel blockers
They release the musculature that lines the vessels by inhibiting the entry of calcium into the smooth muscle cells that make up one of the layers of the vascular wall.
In this way a vasodilation is obtained that allows the reduction of pressure values. The phenomenon is similar to that determined by ACE inhibitors, but occurs through different mechanisms.
Verapamil, dilitiazem, amlodipine, nifedipine belong to this class of drugs.
Sartans
They are new generation drugs that to reduce blood pressure operate directly on the hormone angiotensin II, responsible for the tension of the vascular walls.
They act by blocking the receptors that bind this hormone, through which angiotensin exerts its action at the level of the vessels.
The inhibition of angiotensin determines a vascular dilatation and the consequent reduction of pressure values. Among the sartans are telmisartan, losartan, valsartan, irbesartan, candesartan.
Joycelyn Elders is the author and creator of EmpowerEssence, a health and wellness blog. Elders is a respected public health advocate and pediatrician dedicated to promoting general health and well-being.
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