Chapter 2 Book Antihypertensive Therapies Notes

Medications for High Blood Pressure (Hypertension)

What Is Hypertension?

• High blood pressure = heart pumping too hard or blood vessels being too tight.

• We treat it to prevent heart attacks, strokes, kidney damage, and other problems.

• Goal: Get blood pressure below 140/90 mmHg (or even lower in some people).

Main Types of Blood Pressure Medicines

1. Diuretics (“Water Pills”)

• Help the body get rid of extra salt and water.

• Lowers blood pressure by decreasing the amount of fluid in the blood.

• Example: Hydrochlorothiazide.

2. Beta Blockers

• Slow down the heart and make it pump with less force.

• Lower the amount of work the heart has to do.

• Best for younger people or those with fast heartbeats.

• Example: Metoprolol.

3. ACE Inhibitors / ARBs

• Block a hormone (angiotensin II) that tightens blood vessels.

• This helps relax blood vessels and lower pressure.

• Also protect kidneys in people with diabetes.

• ACE Example: Lisinopril | ARB Example: Losartan.

4. Calcium Channel Blockers

• Stop calcium from entering heart and blood vessel cells.

• Make blood vessels relax and sometimes slow the heart.

• Dihydropyridines (like Amlodipine) relax vessels.

• Non-dihydropyridines (like Verapamil) work more on the heart.

5. Alpha Blockers

• Open up blood vessels by blocking alpha receptors.

• Not used often, but may be added in some cases.

• Example: Doxazosin.

6. Vasodilators

• Directly relax blood vessels.

• Usually added when other medicines aren’t enough.

• Example: Hydralazine.

7. Other Medicines

• Work on the brain or nervous system to lower blood pressure.

• Example: Clonidine.

How Doctors Choose the Right Medicine

• Depends on your age, race, other health conditions (like diabetes or heart problems).

• Most people need 2 or more medications to control blood pressure.

Resistant Hypertension

• This means your BP is still high after trying 3 different meds.

• Best add-on: Spironolactone (a water pill that blocks a hormone called aldosterone).

Common Side Effects to Watch For

Quick Summary

• High blood pressure is common and treatable.

• Medicines work by lowering fluid, relaxing vessels, or slowing the heart.

• Most people need a combination of meds.

• Spironolactone is often used if others don’t work well enough.