The best pills for high blood pressure

Blood pressure is one of the basic indicators of health, reflecting the work of not only the cardiovascular system, but also the activity of the kidneys, endocrine organs, hematopoiesis and the nervous system. Therefore, hypertension is a very general concept, reflecting an episodic or persistent increase in pressure. Therefore, there is simply no universal and single cure for “pressure”. You can’t come to the pharmacy and ask “give me blood pressure pills”, because the pharmacist will immediately ask – what kind of drug did the doctor prescribe for you, what specific medicine do you need?

The best pills for high blood pressure: do they exist?

First of all, let’s say that hypertension happens:

• Primary, that is, it is considered an independent pathology, in which an increase in pressure is the leading symptom. Often this pathology is referred to as essential hypertension or essential hypertension. It can be mild, moderate or severe, with crises and the threat of serious, fatal complications.
• Secondary, when an increase in pressure is just one of many other symptoms, for example, in diseases of the kidneys, nervous system, thyroid gland, adrenal glands.

Accordingly, it is already clear that there is no single method of treating hypertension. Therefore, the doctor selects the pills for high blood pressure individually, from a huge variety of drugs that are sold today in pharmacies, both without a prescription and strictly on prescription. Many of the drugs that were used 30-50 years ago have already gone out of circulation, they are not included in modern therapy protocols due to the risk of side effects and complications (for example, Clonidine or Reserpine). Part of the drugs that actively reduce pressure are used only by emergency doctors, they are administered intravenously or intramuscularly in hypertensive crises.

Hypertension is a chronic progressive disease and its treatment must be continuous. To maintain indicators within safe limits, you need to choose the best pills for high blood pressure, but this should be done only after an accurate diagnosis has been made and only in conjunction with a therapist or cardiologist.

Top 15 rating according to KP

We spoke with experts and identified the most commonly prescribed and well-proven remedies. They can be combined with each other at the discretion of the doctor, depending on the diagnosis and clinical situation.

Calcium antagonists

1. Diltiazem

It is a prescription drug, available in capsules and tablets, for people with severe heart problems due to hypertension.

Показания:

• arterial hypertension;
• prevention of angina attacks (retrosternal pain);
• prevention of various types of arrhythmias (atrial fibrillation and flutter, extrasystoles, supraventricular paroxysms).

The drug is contraindicated in patients with low heart rate, atrio-vetericular blockade, heart attacks, liver problems. It can be administered with beta-blockers very carefully, there may be negative effects.

2. Verapamil

Tablets, forms of “prolong” or solution for intravenous administration, refers to prescription drugs of the calcium antagonist group.

Показания:

• treatment of arterial hypertension;
• prevention of angina attacks (pain in the heart area);
• prevention of supraventricular arrhythmias.

Contraindications for the drug are quite extensive, and it is important that the doctor takes them all into account when deciding on the prescription of the drug. This is especially important for people who have had a heart attack, have kidney problems, heart block and left ventricular failure (CHF).

3. Norvasc (Amlodipine)

Tablets in different dosages, dispensed strictly according to the doctor’s prescription. They belong to the group of “slow” calcium channel blockers. Eliminate myocardial ischemia and high blood pressure, relax smooth muscle cells in the vessels.

Показания:

• treatment of arterial hypertension (both in the form of a single drug, and in combination with other groups);
• treatment of stable, angiospastic forms of angina pectoris (also, possibly as part of a combined treatment).

The drug is prohibited for use with frequent hypotonic attacks and the presence of severe heart failure, an acute period of infarction. Effects are enhanced when taken with diuretics, nitrates, or beta-blockers.

Diuretics

4. Veroshpiron

The drug is available in capsules or tablets, belongs to the group of prescription drugs. It is a potassium-sparing diuretic, which means it does not lead to the loss of a mineral necessary for heart function. It works by blocking the hormone aldosterone, which is secreted by the adrenal glands to retain fluid.

Показания:

• treatment of arterial hypertension (usually in combined regimens);
• elimination of edematous syndrome;
• in the treatment of problems with the adrenal glands;
• in the elimination of edema caused by problems with the liver and kidneys.

Contraindicated in high levels of potassium, calcium or sodium in the blood, Addison’s disease, renal failure. It is used very carefully in diabetics and the elderly, atrioventricular forms of heart block.

5. Indapamide

Tablets in the form of retard and prolong, sold by prescription, belong to the group of thiazide diuretics. Stimulates the excretion of chloride and sodium ions in the urine, due to which excess water also leaves. Additionally, it helps to relax blood vessels, reduces the load on the myocardium.

Показания:

• treatment of arterial hypertension.

Contraindicated in severe kidney failure, damage to the liver and brain (encephalopathy), low levels of potassium in the blood. Do not take with drugs that affect myocardial contractility.

6. Triampur

Combined diuretic of two drugs – potassium-sparing and thiazide diuretics. Available in tablets, sold by prescription. It leads to increased excretion of ions in the urine, due to which water is also lost.

Показания:

• treatment of arterial hypertension (in combination therapy);
• elimination of edematous syndrome against the background of lesions of the kidneys, liver.

Contraindicated in end-stage kidney and liver failure, low levels of potassium and other electrolytes, a decrease in blood volume in the vessels and hypotension. It is used very carefully in people with diabetes, urolithiasis, folate deficiency and alcoholism.

ACE inhibitors

7. Zocardis

Tablets in two dosage forms, dispensed by prescription. Reduces blood pressure by suppressing the production of the hormone angiotensin, thereby reducing the release of the antidiuretic hormone aldosterone. The drug reduces the load on the heart, reduces systolic and diastolic pressure, dilates the arteries without increasing the heart rate.

Показания:

• Mild and moderate stages of hypertension;
• Myocardial infarction in the acute stage, if the person has not received thrombolytic drugs and blood circulation is not disturbed.

The drug is contraindicated in case of severe damage to the liver and kidneys, intolerance or allergy to the components of the drug.

8. Captopril (Capoten)

Tablets in different dosages are dispensed by prescription. The drug inhibits the release of angiotensin, eliminates spasm of the arteries, reduces the load on the heart and blood vessels, reducing pressure in both the large and small circles.

Показания:

• arterial hypertension, including renal origin;
• chronic heart failure (in combination with other drugs);
• violation of the contraction of the left half of the heart after a heart attack;
• kidney damage in diabetes mellitus (nephropathy).

The drug is used very carefully for lesions of the renal vessels, against the background of taking hypoglycemic drugs, with autoimmune lesions, high levels of potassium in the plasma.

9. Prestarium

Tablets in different dosages, dispensed by prescription. They help block angiotensin, which leads to spasm of the arteries and an increase in the load on the heart, does not affect the frequency of myocardial contractions. Helps in normalizing the condition in coronary heart disease (CHD), improves blood circulation in the brain.

Показания:

• treatment of arterial hypertension;
• combination therapy for ischemic heart disease, a stable form to reduce the risk of complications;
• treatment of chronic heart failure;
• prevention of recurrent stroke.

Caution should be used together with diuretics, with angina pectoris, with severe damage to the kidneys and their vessels, against the background of autoimmune diseases.

Beta blockers

10. Bisoprolol

Tablets in different dosages are prescribed by prescription, belong to the group of selective beta-blockers. They reduce the heart rate, myocardial oxygen demand, reduce the risk of angina pectoris, arrhythmias and lower blood pressure. Due to selectivity, they have little effect on other organs with adrenergic receptors.

Показания:

• treatment of arterial hypertension;
• therapy for coronary artery disease, reducing the risk of angina attacks.

Prohibited for admission in acute and severe chronic heart failure, with severe heart block, with bronchial asthma, low heart rate (less than 55 – 60 bpm). Use with caution with diuretics and other groups of drugs.

11. Atenolol

Tablets are released strictly according to the prescription, have different dosages. Belongs to the group of selective blockers. It normalizes blood pressure by reducing the frequency of heart contractions, reduces the load on the heart muscle, and eliminates arrhythmias.

Показания:

• treatment of arterial hypertension;
• prevention of angina attacks;
• treatment of cardiac arrhythmias (tachycardia, extrasystoles).

Prohibited for admission with severe blockade and bradycardia, with bronchial asthma, an increase in heart size with CHF.

12. Metoprolol

Tablets in different dosages are sold only by prescription. Refers to selective beta-blockers, reduces the contractility of the heart and the load on it, normalizes the rhythm. Reduces the effect of renin on blood vessels and kidneys, normalizing blood circulation in the vessels.

Показания:

• treatment of arterial hypertension;
• treatment of chronic heart failure (in combination with other drugs);
• IHD therapy and prevention of its complications;
• arrhythmias with tachycardia and extrasystoles;
• prevention of migraine attacks.

Prohibited for admission with severe blockade and bradycardia, with bronchial asthma, an increase in heart size with CHF, with pheochromocytoma, severe heart block.

Angiotensin receptor blockers (sartans)

13. Valsartan

Tablets in different dosages are released strictly according to prescriptions. Reduces pressure due to the effect on angiotensin, blocking its activity without side effects, does not affect the heart rate. The effect is especially significant for kidney problems and against the background of diabetes.

Показания:

• treatment of arterial hypertension;
• correction of heart failure 1 – 2 stages;
• improvement of heart function after myocardial infarction.

Prohibited for admission in severe liver and kidney damage, it should be used with caution against the background of certain hypoglycemic drugs, with a diet with salt restriction.

14. Losartan

The drug in tablets with different dosages, sold strictly by prescription, is used with an increase in pressure against the background of concomitant pathologies (including heart failure and diabetes). Reduces the load on the myocardium, helps it to better feed on oxygen.

Показания:

• treatment of arterial hypertension;
• reduced risk of fatal complications in left ventricular hypertrophy;
• therapy for diabetes mellitus to protect the kidneys;
• treatment of CHF if other drugs are not effective.

It is forbidden to use simultaneously with ACE inhibitors, especially with kidney problems, some hypoglycemic drugs, against the background of lactose intolerance.

15. Cardozal

The drug of the sartans group, the tablets have different dosages, they are released only by prescription. They help in reducing pressure and reducing the load on the myocardium, normalizing its nutrition.

Показания:

• Treatment of hypertension.

Contraindicated in patients with lesions of the liver and gallbladder, with severe kidney failure. Carefully prescribed for ischemic heart disease and heart failure, especially in old age.

How to choose pills for high blood pressure

Firstly, on your own, even if you know your diagnosis, you cannot choose drugs. To date, there are 6 classes of drugs against high blood pressure, and they all have a different principle of action and a list of indications and, most importantly, contraindications. If you choose a medicine on the advice of a neighbor, articles from the Internet, or just at random because you heard the name of this medicine, you can not only not reduce pressure, but worsen your condition.

When choosing pills for pressure or drugs in any other form (capsules, injections, intravenous infusions), the doctor is guided by a number of criteria. This is the age of the patient, associated health problems (high cholesterol, kidney problems, hormonal imbalance, diabetes, obesity), vascular reactions, upper and lower blood pressure figures. The following groups of drugs may be prescribed:

• Beta blockers. These are drugs that lower blood pressure by slowing the heart rate. If the heart works slower, it pumps less blood and delivers it to the vessels at lower pressure. These pills are not without side effects – skin rashes are possible, too much slowing of the pulse, which causes weakness and malaise.
• Diuretics (the second name is diuretics). They help to expel excess water from the tissues and blood vessels, thus lowering the level of blood pressure. They also have a number of side effects – they negatively affect the contractility of the heart, they can provoke nausea, convulsions, dizziness, a feeling of numbness in the fingers or crawling (as salts are lost).

• Angiotensin-converting enzyme inhibitors (or more simply i-ACE). In the body of hypertensive patients, too much of a special hormone, angiotensin, is synthesized, which leads to vasospasm and fluid retention, and an increase in pressure. Medicines from this group block the work of enzymes that help in the synthesis of this hormone. Less hormone – less and spasm of blood vessels, lower pressure. There are not very many side effects of drugs, but allergies and intolerance to drugs are possible, as well as coughing fits that literally plague hypertensive patients.
• Angiotensin antagonists. These are drugs with the opposite effect on this hormone. If the hormone acts on the walls of blood vessels, it spasms them and increases pressure, the drugs suppress the activity of the hormone by binding to its receptors. Side effects from taking these drugs are often nausea with dizziness, a sharp decrease in vascular tone and pressure.
• calcium antagonists. Calcium ions are responsible for the tone of arterial vessels, and drugs in this group help to relax the vascular walls, which leads to a decrease in blood pressure. Side effects from such drugs are tachycardia (the heart beats faster) and bouts of dizziness.

Important! Often, doctors use more than one drug, but a combination of 2-3 drugs from different groups, so that the effect is more pronounced and the number of side effects decreases. In addition, the dose is selected gradually, over 3 to 6 months, until the most optimal combination of several agents is obtained that maintains pressure at a stable and safe level.

Sometimes the doctor supplements the basic therapy (drugs that you need to drink daily) with more medicines that are taken during crises, if the pressure jumps sharply and strongly. And the dose is also chosen very individually. That is why it is impossible to name the best pressure pills, in each case it will be its own combination that is right for you.

Popular questions and answers

We discussed the management of patients with hypertension and the prescription of drugs to reduce pressure with general practitioner, endoscopist, head of the organizational and methodological office Lidia Golubenko.

Any medications have side effects and contraindications. Our rating is an overview and is not a guide to action. Before buying drugs, consult your doctor.