Untangling the confusion over blood-pressure drugs
Q. I heard that taking beta-blockers for high blood pressure is not a good idea. I take a beta-blocker, so should I ask my doctor to take me off it?
A recent study found that beta-blockers may increase the risk of having a heart attack or stroke if you are using them to treat high blood pressure alone. If you are taking a beta-blocker, discuss it with your doctor. Warning: Don't stop taking the drug on your own.
More than half of Americans over age 60 have high blood pressure. Many people with high blood pressure need more than one medication to treat it. So, I've received many questions about blood-pressure drugs.
There's a lot of confusion about these medications because there are so many of them and they work in a variety of ways. Today's column is devoted to clearing up some of the confusion.
Beta-blockers make your heart beat more slowly and with less force. Your heart pumps less blood and your pressure goes down.
The following are the brand names for common beta-blockers: Sectral, Tenormin, Kerlone, Zebeta, Cartrol, Tandate, Lopressor, Toprol XL, Corgard, Levatol, Visken, Inderal, Betapace, and Blocadren.
Angiotensin-converting enzyme (ACE) inhibitors
ACE inhibitors keep your body from making angiotensin II, a hormone that normally causes blood vessels to narrow. ACE inhibitors expand blood vessels so your blood pressure goes down.
The following are common ACE inhibitors: Lotensin, Capoten, Vasotec, Monopril, Prinivil, Zestril, Univasc, Aceon, Accupril, Altace, and Mavik.
Angiotensin II receptor blockers (ARBS)
ARBS are like ACE inhibitors because they protect against angiotensin II. ARBS don't lower levels of the hormone; they prevent this chemical from affecting the heart and blood vessels.
The following are common ARBS: Atacand, Teveten, Avapro, Cozaar, Benicar, Micardis, and Diovan.
Calcium channel blockers
These drugs block calcium from entering the muscle cells of the heart and blood vessels. This relaxes blood vessels and lowers blood pressure.
The following are common calcium channel blockers: Norvasc, Cardizem, Dilacor XR, Tiazac, Plendil, DynaCirc CR, Cardene, Adalat CC, Procardia, Nimotop, Sular, Calan, Covera HS, Isoptin, and Verelan.
Diuretics, also known as "water pills," help the kidneys flush extra water and salt from your body and decrease blood volume to lower pressure.
The following are common diuretics: Midamor, Bumex, Diuril, Hygroton, Thalitone, Lasix, Esidrix, Hydrodiuril, Saluron, Lozol, Enduron, Zaroxolyn, Aldactone, Demadex and Dyrenium.
Vasodilators open blood vessels by directly relaxing the muscle in the vessel walls.
Common vasodilators are Apresoline and Loniten.
Alpha blockers, also called alpha-adrenergic antagonists, reduce nerve impulses that tighten blood vessels; this permits blood to flow more freely.
Common alpha blockers are: Cardura, Minipress, Minizide, Hytrin, Flomax and Uroxatral.
These drugs work two ways: they reduce nerve impulses to blood vessels and slow the heartbeat.
Common alpha-beta blockers are Coreg and Normodyne.
Central-acting agents work by preventing your brain from sending signals to your nervous system to speed up your heart rate and narrow your blood vessels.
The following are examples: Catapres, Clorpres, Combipres, Wytensin, Tenex, Aldomet, Aldochlor, and Aldoril.
There are a variety of preparations that combine medications. For example, Cozaar, which is an ARB, is combined with a diuretic, to form Hyzaar.
The following are other popular combination drugs:
Lexxel, Lotrel, Tarka, Tenoretic, Ziac, Corzide, Inderide, Timolide, Lotensin, Vaseretic, Prinzide, Zestoretic, Uniretic, Accuretic, Avalide, and Diovan HCT.
Renin inhibitors are a relatively new type of blood pressure drug. As the name indicates, they inhibit renin, which is an enzyme secreted by the kidneys that is involved in the release of angiotensin.
Tekturna is a renin inhibitor.
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