MANAGEMENT OF HYPERTENSION

The first step to managing hypertension is lifestyle modification. If the BP is not responding well to lifestyle modification, the drug therapy will be the next step. Below are classes of drugs used listed, your healthcare provider will choose the one appropriate for you.

Calcium channel blockers,  CCBs

Calcium channel blockers can also be grouped into several classes depending on their structural composition

Calcium channel blockers reduce blood pressure by widening your blood vessels.

Common examples are amlodipine, nicardipine, felodipine and nifedipine, diltiazem , verapamil. It should be noted that verapamil and diltiazem have more affinity for calcium channels in the heart.

Possible side effects include headaches, swollen ankles and constipation.

Beta-blockers

Beta-blockers can reduce blood pressure by reducing the contractility of the heart thereby making your heart beat more slowly and with less force.

They may have devastating effect in patient with left ventricular heart failure and should not be given in this case.

They are also contraindicated in hypertensive asthmatic patients because they worsen asthma by their induced bronchoconstriction via beta receptor in the respiratory pathway

Common examples are timolol, propanolol, atenolol , bisoprolol and metoprolol.

The beta-antagonists that are still very much in use are those ones that are selective.

Possible side effects include decreased libido, dizziness, headaches, tiredness, and cold hands and feet.

ACE inhibitors

Angiotensin-converting enzyme (ACE) inhibitors reduce blood pressure by dilating blood vessels especially the peripheral vasculatures. ACE inhibitors are very useful in patients with co-morbidity as well preventing end-organ damage which is mostly associated with HTN

Common examples are enalapril, lisinopril, perindopril and ramipril.

The most noticeable side effect is a persistent unproductive cough. Other possible side effects include headaches, dizziness and a rash.

Angiotensin-2 receptor blockers (ARBs)

ARBs work in a similar way to ACE inhibitors. They're often recommended if ACE inhibitors cause troublesome side effects.

ARBs have no or less effect on bradykinin level and so are not likely to dry cough associated with ACE inhibitors.

Common examples are candesartan, irbesartan, losartan, valsartan and olmesartan.

Possible side effects include dizziness, headaches, and cold or flu-like symptoms.

ACE inhibitors and ARBs can be grouped together as RAAS which means rennin-angiotensin-aldosterone system which highlights the mechanism of their action.

Diuretics

Diuretics work by removing excess salt and water from the body through urine. There exist different types of diuretics so your healthcare provider will prescribe the one appropriate for you after adequate assessment.

Common examples are ,hydrochlorthiazide HCT, moduretic, indapamide and bendroflumethiazide.

Possible side effects include postural hypotension, increased thirst, and frequent urination

 Hypokalaemia and hyponatraemia are common so electrolyte level must be monitored.

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