Friday, January 30, 2015

Hypertension - Remaining Part

High Blood Pressure and Calcium Channel Blockers

Calcium channel blockers are drugs used to lower blood pressure. They work by slowing the movement of calcium into the cells of the heart and blood vessel walls, which makes it easier for the heart to pump and widens blood vessels. As a result, the heart doesn't have to work as hard, and blood pressure lowers.

Examples of calcium channel blockers include:
·         Norvasc (amlodipine)
·         Plendil (felodipine)
·         DynaCirc (isradipine)
·         Cardene (nicardipine)
·         Procardia XL, Adalat (nifedipine)
·         Cardizem, Dilacor, Tiazac, Diltia XL (diltiazem)
·         Sular (Nisoldipine)
·         Isoptin, Calan, Verelan, Covera-HS (verapamil)


Side Effects of Calcium Channel Blockers
Potential side effects from taking a calcium channel blocker include:
·         Dizziness or lightheadedness
·         Low blood pressure
·         Heart rhythm problems
·         Dry mouth
·         Edema (swelling of ankles, feet, or lower legs)
·         Headache
·         Nausea
·         Fatigue
·         Skin rash
·         Constipation or diarrhea
·         Gastroesophageal reflux disease (GERD)

High Blood Pressure and ACE Inhibitors
Angiotensin converting enzyme (ACE) inhibitors are high blood pressure drugs that widen or dilate the blood vessels to improve the amount of blood the heart pumps and to lower blood pressure. ACE inhibitors also increase blood flow, which helps to decrease the amount of work your heart has to do and can help protect your kidneys from the effects of hypertension and diabetes.

ACE inhibitors are used to treat a number of heart-related conditions, including high blood pressure, heart failure, heart attack, and preventing kidney damage associated with high blood pressure and diabetes.

Examples of ACE inhibitors include:
·         Capoten (captopril)
·         Vasotec (enalapril)
·         Prinivil, Zestril (lisinopril)
·         Lotensin (benazepril)
·         Monopril (fosinopril)
·         Altace (ramipril)
·         Accupril (quinapril)
·         Aceon (perindopril)
·         Mavik (trandolapril)
·         Univasc (moexipril)

What Are the Side Effects of ACE Inhibitors?
Like any drug, an ACE inhibitor is likely to have some side effects. They may include:
·         Cough. If this symptom persists or is severe, contact your doctor. Ask your doctor what type of cough medicine you should use to control the cough.
·         Red, itchy skin. Contact your doctor; do not treat the rash yourself.
·         Dizziness, light headedness or faintness upon rising. This side effect may be strongest after the first dose, especially if you have been taking a diuretic (water pill). Get up more slowly. Contact your doctor if these symptoms persist or are severe.
·         Salty or metallic taste or a decreased ability to taste. This effect usually goes away as you continue taking the medication.
·         Physical symptoms. Sore, fever, mouth sores, unusual bruising, fast or irregular heartbeat, chest pain, and swelling of feet, ankles and lower legs. Contact your doctor if you have any of these symptoms.
·         Swelling of your neck, face, and tongue. See a doctor right away if you have any of these symptoms. These represent a serious emergency.
·         Potassium levels. This is a potentially life-threatening complication. Therefore, people on ACE inhibitors should regularly have blood tests to measure potassium levels. Signs of too much potassium in the body include confusion, irregular heartbeat, nervousness, numbness or tingling in hands, feet or lips, shortness of breath or difficulty breathing, and weakness or heaviness in legs. Contact your doctor right away if you have any of these symptoms.
·         Kidney failure. Although ACE inhibitors help to protect the kidneys, it can also cause kidney failure in some people.
·         Severe vomiting or diarrhea. If you have severe vomiting or diarrhea you may become dehydrated, which can lead to low blood pressure. Contact your doctor right away.

High Blood Pressure and Angiotensin II Receptor Blockers (ARBs)

Angiotensin II receptor blockers (ARBs) have the same effects as ACE inhibitors, another type of blood pressure drug, but work by a different mechanism. These drugs block the effect of angiotensin II, a chemical that narrows blood vessels. By doing so, they help widen blood vessels to allow blood to flow more easily, which lowers blood pressure. ARBs are generally prescribed for people who cannot tolerate ACE inhibitors.

Examples of ARBs include:
·         Atacand (candesartan)
·         Avapro (irbesartan)
·         Benicar (olmesartan)
·         Cozaar (losartan)
·         Diovan (valsartan)
·         Micardis (telmisartan)
·         Teveten (eprosartan)

What Are Some of the Side Effects?
Some of the side effects of taking ARBs include:
·         Dizziness, lightheadedness, or faintness upon rising, This side effect may be strongest after the first dose, especially if you have been taking a diuretic (water pill). Contact your doctor if these symptoms are persistent or severe.
·         Physical problems. Diarrhea, muscle cramps or weakness, back or leg pain, insomnia (difficulty sleeping), irregular heartbeat, or fast or slow heartbeat, sinusitis or upper respiratory infection. Contact your doctor if these symptoms are persistent or severe.
·         Confusion. Contact your doctor right away.
·         Severe vomiting or diarrhea. If you become sick with severe vomiting or diarrhea you may become dehydrated, which can lead to low blood pressure. Contact your doctor.
·         Abnormalities in blood chemistry laboratory tests.
·         Cough, though less commonly than with ACE inhibitors.

High Blood Pressure and Beta-Blockers

Beta-blockers are drugs used to treat high blood pressure. They block the effects of the sympathetic nervous system on the heart. This reduces the work of the heart so that it requires less blood and oxygen. As a result, the heart doesn't have to work as hard, which in turn lowers blood pressure. Beta-blockers help control heart rate and are also used in the treatment of abnormal heart rhythms that may too fast or irregular.

There are several beta-blockers available, including:
·         Sectral (acebutolol)
·         Tenormin (atenolol)
·         Kerlone (betaxolol)
·         Zebeta, Ziac (bisoprolol)
·         Coreg (carvedilol)
·         Normodyne, Trandate (labetalol)
·         Lopressor, Toprol-XL (metoprolol)
·         Corgard (nadolol)
·         Nebivolol (bystolic)
·         Levatol (penbutolol)
·         Visken (pindolol)
·         Inderal, Inderal LA (propanolol)
·         Blocadren (timolol)


Side Effects of Beta-Blockers
Potential side effects of beta-blockers include:
·         Dizziness or lightheadedness
·         Problems with sexual performance and ability
·         Sleeping problems and drowsiness
·         Fatigue
·         Cold hands and feet
·         Slow heartbeat
·         Edema (swelling in ankles, feet, or legs)
·         Trouble breathing, especially asthma symptoms
·         Depression

Omega-3 Fish Oil Supplements for High Blood Pressure
In the past 10 years, many Americans have turned to omega-3 fish oil supplements. Dietary fish and fish oil supplements have benefits for healthy people and also those with heart disease.
Omega-3 fish oil contains both docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). Omega-3 fatty acids are very important in preventing and managing heart disease.

Findings show omega-3 fish oil may help to:
·         Lower blood pressure
·         Reduce triglycerides
·         Slow the development of plaque in the arteries
·         Reduce the chance of abnormal heart rhythm
·         Reduce the likelihood of heart attack and stroke
·         Lessen the chance of sudden cardiac death in people with heart disease

 How much omega-3 fish oil is safe?
The AHA says taking up to 3 grams of fish oil supplements daily is considered safe. Don't take more than that unless you discuss it with your doctor first. 

Are there side effects with omega-3 fish oil?

Side effects from omega-3 fish oil may include:
·         a fishy taste in your mouth
·         fishy breath
·         stomach upset
·         loose stools
·         nausea

Taking more than 3 grams of fish oil daily may increase the risk of bleeding.