Dorothy FarrarAntihypertonika (Antihypertensivum)
Antihypertensives (antihypertensives) are medicines that lower blood pressure and are used to treat high blood pressure. They are also known as antihypertensive drugs.
What are antihypertensives?
All drugs that lower blood pressure are classified as antihypertensives. In most cases, however, antihypertensives have other effects, so that they are also used for the (concomitant) treatment of other diseases. Within the group of antihypertensives there are different active substances. These include ACE inhibitors , diuretics , beta blockers , alpha blockers, renin inhibitors, and calcium channel blockers. The treatment of hypertension often proves to be difficult, so that several active ingredients are often prescribed in combination.
Effect and medical application
Antihypertensives are designed to lower blood pressure to a physiological level. The individual active ingredients act at different points. Diuretics are water pills that increase the amount of water flushed out by the kidneys . With the increased water excretion, more electrolytes are also excreted. As a result, blood pressure drops.
Beta blockers, also known as beta-receptor blockers, block the β-adrenoceptors in the human body and thus inhibit the effects of the hormone adrenaline and the neurotransmitter noradrenaline . This lowers the resting heart rate and blood pressure. Calcium antagonists are also called calcium channel blockers in the narrower sense. They prevent or reduce the influx of calcium ions into the interior of muscle cells. As a result, the cells of the smooth muscle can no longer contract as well.
As a result, blood vessels dilate, which in turn lowers blood pressure. Some of the calcium channel blockers not only have an effect on the blood vessels, but also on the heart . The so-called phenylalkylamines have a strong effect on the spread of excitation in the heart and on the heart’s ability to beat. ACE inhibitors inhibit angiotensin converting enzyme (ACE). This angiotensin-converting enzyme is an important part of the renin-angiotensin-aldosterone mechanism. By inhibiting the angiotensin converting enzyme , less aldosterone is released. Since aldosterone has a blood pressure-increasing effect, blood pressure falls or stops rising.
The AT1 antagonists are also angiotensin II receptor subtype 1 antagonists. They also interfere with the renin-angiotensin-aldosterone mechanism by blocking the subtype 1 angiotensin II receptor. Angiotensin causes vasoconstriction and thus an increase in blood pressure. By blocking the receptor, this effect does not occur. Renin antagonists act directly at the beginning of the renin-angiotensin-aldosterone cycle.
shapes and groups
Depending on the site of attack and the mechanism of action, diuretic antihypertensives can be divided into loop diuretics, thiazide diuretics and potassium-sparing diuretics. Loop diuretics include the preparations Diurapid®, Furosal®, Fusid®, Jufurix® and Lasix®. Burinex®, Bumex®, Lixil® and Lunetoron® are also loop diuretics. On the other hand, Disalunil®, Esidrex® and Esidrix® are among the thiazide diuretics. Amiloretik®, Comilorid®, Tensoflux®, Moducrin®, Kalten® and Loradur are thiazide diuretics.
Well-known drugs from the group of beta blockers are Altenolol®, Atebeta®, Tenormin®, Cuxanorm®, Carvedilol®, Querto®, Dilatrend®, BisoHEXAL®, Biso-Henning® and Bisogamma®. The most well-known active ingredient from the group of ACE inhibitors is ramipril. This drug is contained in Delix®, Hypren®, Vesdil®, Triatec®, Tritace® and Vasotop®, among others. The combination preparations Lasitace®, Tonotec®, Arelix®, Unimax® and Delmuno® also contain ramipril. Verapamil®, Gallopamil®, Diltiazem®, Nitrendipin®, Amlodipin®, Nimodipin®, Clevidipin®, Nifedipin® and Nicardipin® also belong to the antihypertensive drugs and are calcium antagonists.
Dosage
The dosage of antihypertensives depends on the severity of the disease and the preparation in question. If the high blood pressure does not decrease within four weeks, the dose must be adjusted.
Herbal, natural and pharmaceutical alternatives
The Rauwolfia is a medicinal plant that is mainly used to treat heart problems and high blood pressure as an antihypertensive. Since Rauwolfia has a very strong effect and is toxic in higher doses, it may only be prescribed by a doctor or used in homeopathic doses. Mistletoe can also be helpful for high blood pressure. It contains various alkaloids , asparagine, bitter substances and the mistletoe-specific active ingredients viscin and viscalbin.
The tea that is used to lower high blood pressure must always be used as a cold extract. Another antihypertensive plant is hawthorn . It strengthens the heart, stimulates blood circulation and expands blood vessels. The calming effect of passion flower can also have a positive effect on blood pressure.
Interactions and side effects
Common and important side effects of calcium channel blockers include edema in the legs, slow heartbeat (bradycardia), fast heartbeat ( tachycardia ), allergic reactions , impotence , dizziness , headache and constipation. Increased growth (hyperplasia) of the gums with subsequent severe inflammation is also observed in some patients.
Diuretics are generally fairly well tolerated and have a high therapeutic index. However, they can lead to dehydration due to excessive water loss and also to a lack of salt. Such hyponatremia is manifested by confusion , seizures, and leg cramps. Hypokalemia leads to cardiac arrhythmia . On the other hand, potassium-sparing diuretics can cause an excess of potassium in the blood. The diuretics also thicken the blood , increasing the risk of thrombosis. In the case of an overdose, the blood pressure can drop so much that hypotension develops.
Beta blockers are actually well tolerated. Most side effects are also reversible. This means that the symptoms disappear after the drug is stopped. Possible side effects of antihypertensives from the group of beta blockers are cardiac insufficiency , asthma attacks , cardiac conduction disorders, fatigue , depressive moods and circulatory disorders . Men can experience erectile dysfunction when taking beta-blockers. In patients with psoriasis (psoriasis), the symptoms of the disease can be aggravated by the beta-blockers.
One of the most common side effects of ACE inhibitors is a dry cough . This is caused by slower breakdown and accumulation of bradykinin. As a result, side effects such as hypotension, acute renal failure and hyperkalemia can also develop.
In addition , growth and bone formation disorders can occur in the unborn child during pregnancy . ACE inhibitors are therefore contraindicated during pregnancy.
Hello and welcome to my Health Guide & Encyclopedia! My name is Dorothy Farrar, and I'm the founder and main author of this platform.
My passion for health and wellness started at a young age when I became interested in the connection between the food we eat and the way we feel. This fascination led me to study nutrition and dietetics in college, where I learned about the importance of a balanced diet and the impact of various nutrients on the body.