Blood Pressure Medication Treatment Options

In the pharmacy, it is not uncommon to have a patient call in for their blood pressure medication refill only to see that they are 1-2 weeks late filling their prescription.  Quite often, when queried about the reason for the late refill, I get one of two answers.
  • “I don’t feel like my blood pressure is high, why do I need to take my medications?”
  • “I don’t like how I feel after I take this medication.”
In answer to the first question, I like to share a plumbing analogy.  Similar to the plumbing system in our house, we have a circulatory system in our body comprised of a pump (our heart), water pipes (our blood vessels), and a faucet (our kidneys and urinary tract).  If the water pressure gets too high in our house, we need to adjust the system to keep the plumbing from breaking down.  Similarly, we have medications that will decrease the amount of fluid the heart pumps, medications that will relax our blood vessels, and medications that will increase the flow of fluid out of our kidneys.  All Three of these mechanisms will decrease our blood pressure; however, your doctor needs to evaluate your entire system to see which mechanism is most appropriate for any given situation.

Simple answer, if high blood pressure is left untreated, the blood vessels will harden and this will eventually lead to a heart attack or a stroke.  Increased blood pressure will damage the vessels that supply the retina with blood and lead to vision problems.  Furthermore, the filtering cells in the kidneys will become damaged and lead to kidney failure.  Lastly, the heart will tire from pumping against the increased pressure and eventually lead to heart failure.

During the first 2-4 weeks of treatment with any blood pressure medication it is a good idea to monitor your blood pressure on a daily basis.  This can be done with your own blood pressure machine, with an automatic machine in a store, or at the doctor's office.  It is recommended that you keep a log of the results and the time of day the reading is taken so that you can pass the information on to your doctor.  Let your doctor know as soon as possible if your blood pressure remains high.

In response to the second question, I like to first find out a few more specifics about what “feeling” is uncomfortable.  In general, medications used to treat high blood pressure may have a tendency to cause some dizziness, light headedness or tiredness.  Different categories of blood pressure medications have their own set of specific side effects.  If a patient feels uncomfortable on one particular category of medication, it is possible that a different category may work just as well at lowering the blood pressure while providing a much more pleasant side effect profile.

Patients do not always realize that they have options.  Quite often, a patient will take their medication, not like how they feel, and then just stop taking the medication.  I regularly encourage folks to engage their health care provider in educated conversations about their medication treatment.  With the intent of helping patients engage their practitioner in an educated discussion about their blood pressure medication, AudibleRxTM has developed Medication Specific Counseling SessionsTM on many of the currently available treatment options.

Following is a brief description of many different blood pressure medication categories and a listing of the medications that currently have counseling sessions available at the AudibleRxTM website.

Angiotensin Converting Enzyme Inhibitors (ACEI’s):  Please follow this link to read the blog about this category of medications.  This category of medication relaxes the pressure on blood vessels which allows the blood to flow more smoothly.

  • Benazepril (Lotensin-TM)
  • Enalapril (Vasotec-TM)
  • Lisiniopril (Prinivil-TM, Zestril-TM)
  • Quinapril (Accupril-TM)
  • Ramipril (Altace-TM)

Angiotensin Receptor Blockers (ARB’s):  Please follow this link to read the blog about this category of medications.  This category of medication relaxes the pressure on blood vessels which allows the blood to flow more smoothly.

  • Candesartan (Atacand-TM)
  • Irbesartan (Avapro-TM)
  • Losartan (Cozar-TM)
  • Olmesartan (Benicar-TM)
  • Valsartan (Diovan-TM)

Beta Blockers:  Please follow this link to read the blog about this category of medications.  This category of medications works to block the body’s natural chemicals that affect blood vessels and the heart.  This medication may decrease blood pressure by relaxing blood vessels, slowing heart rate and decreasing the strain on the heart.

  • Atenolol (Tenormin-TM)
  • Carvedilol (Coreg-TM)
  • Carvedilol (Coreg CR-TM)
  • Metoprolol (Lopressor-TM)
  • Metoprolol XR (Toprol XR-TM)
  • Nadolol (Corgard-TM)
  • Nebivolol (Bystolic-TM)
  • Propranolol (Inderal-TM)   
  • Propranolol LA (Inderal LA-TM)

Calcium Channel Blockers:  Please follow this link to read the blog about this category of medications. This category of medication works by relaxing the blood vessels in both the vascular system and in the heart.  By doing this, the resistance that the heart needs to pump against is decreased, heart rate is decreased, and the heart does not need to work as hard to pump blood.

  • Amlodipine (Norvasc-TM)
  • Diltiazem ER (Cardizem CD-TM, Dilacor XR-TM, Taztia XT-TM and others)
  • Felodipine (Plendil-TM)
  • Isradipine (Dynacirc CR-TM)
  • Nifedipine ER (Procardia XL-TM, Adalat CC-TM, and others)
  • Nisoldipine (Sular-TM)
  • Verapamil SR (Calan SR-TM, Isoptin SR-TM, and others)

Diuretics: Sometimes called water pills, these medications increase the volume of urine eliminated from your body.  Taking a diuretic helps the body rid itself of excess water and salt, thereby, decreasing blood pressure and excess strain on the heart.  
 
  • Bumetadine (Bumex-TM)
  • Furosemide (Lasix-TM)
  • Hydrochlorathiazide (Esedrix-TM)
  • Metolazone (Zaroxolyn-TM)
  • Torsemide (Demadex-TM)

To learn more about any of the medications listed in this review, please visit AudibleRxTM and register to become a member.  As a member, you will have full access to all of the Medication Specific Counseling SessionsTM for a full five years.

You may also be interested in learning more about:
Heart Rhythm
Anticoagulation

Thanks
Steve

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